Genetic heterogeneity in blast crisis of chronic myelocytic leukemia.

Fourteen patients with lymphoid and mixed blast crisis (BC) of chronic myelocytic leukemia were studied by immunophenotyping and genotyping. Rearrangements of immunoglobulin heavy chain (IgH), T-cell receptor (TcR) gamma and TcR beta genes were detected in all 14, in nine and in four patients, respectively. Interestingly, more than two rearranged bands of IgH gene in three lymphoid BC and two rearranged bands with germ line band in 1 biphenotypic BC indicated the genetic heterogeneity of the blasts. Some blastic transformations are thought to occur at a more immature stage of hematopoietic differentiation than that indicated by the phenotype and genotype of BC cells.