ATHANASIOS THEOLOGIDES, M.D., Ph.D., F.A.C.P.
The prognosis of an individual case of chronic myelocytic leukemia may be uncertain. The criteria for predicting the course of the disease, the response to chemotherapy, and the life expectancy have been unreliable. Recently some of these criteria have been reevaluated, and new, more dependable criteria for an unfavorable course have been introduced. Fever, marked lymphadenopathy, and skin involvement are ominous features. The absence of Philadelphia chromosome, the presence of muramidasuria, and the detection of fibrosis in the bone marrow are unfavorable findings. Increasing basophilia, rising leukocyte alkaline phosphatase values (not resulting from a beneficial effect of chemotherapy but associated with clinical deterioration), appearance of multiple Philadelphia chromosomes, development of aneuploidy or other chromosome abnormalities, and the development of myelofibrosis may herald an impending blastic transformation and the terminal phase of the disease.
THEOLOGIDES A. Unfavorable Signs in Patients with Chronic Myelocytic Leukemia. Ann Intern Med. ;76:95–99. doi: 10.7326/0003-4819-76-1-95
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Published: Ann Intern Med. 1972;76(1):95-99.
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