Shi Yang, Rand Andrew J, Crow Jennifer H, Moore Joseph O, Lagoo Anand S
From the Departments of Pathology and.
Medicine, Duke University Medical Center, Durham, NC.
Am J Clin Pathol. 2015 Jan;143(1):105-19. doi: 10.1309/AJCPWEX5YY4PHSCN.
To compare the features of the blast phase of chronic myelogenous leukemia (CML) in patients treated with tyrosine kinase inhibitors (TKIs) with those in the pre-TKI era.
Sixty-seven patients with blast phase CML were identified in the Duke Pathology database from 1991 to 2011. The morphology and immunophenotype of blasts were evaluated, along with cytogenetic studies and associated findings in the peripheral blood and bone marrow.
In the TKI era, the blasts were more frequently of a type other than the usual myeloid or lymphoid types when compared with the pre-TKI era. Blast phase in TKI-treated patients was associated with a higher peripheral WBC count and a lower blast percentage in the bone marrow. Of the 23 patients with cytogenetic studies during blast phase, additional cytogenetic changes more frequently occurred in patients with an unusual blast type, and some patients showed these changes months before the onset of blast phase.
Blast phase CML in TKI- and non-TKI-treated patients differs in the morphology and immunophenotype of blasts, cytogenetic findings, and associated findings in the peripheral blood and bone marrow.
比较接受酪氨酸激酶抑制剂（TKIs）治疗的慢性髓性白血病（CML）急变期患者与TKI治疗前时代患者的特征。
从杜克病理学数据库中确定了1991年至2011年期间的67例CML急变期患者。评估了原始细胞的形态学和免疫表型，以及外周血和骨髓中的细胞遗传学研究及相关发现。
与TKI治疗前时代相比，在TKI时代，原始细胞更常为非典型的髓系或淋巴系类型。接受TKI治疗的患者急变期与外周白细胞计数较高和骨髓中原始细胞百分比较低相关。在23例急变期进行细胞遗传学研究的患者中，额外的细胞遗传学改变在具有非典型原始细胞类型的患者中更频繁发生，并且一些患者在急变期开始前数月就出现了这些改变。
接受TKI和未接受TKI治疗的患者的CML急变期在原始细胞的形态学和免疫表型、细胞遗传学结果以及外周血和骨髓中的相关发现方面存在差异。
