Blastic transformation of chronic myelocytic leukaemia. Clinical manifestations, prognostic factors and results of therapy.

21 patients with chronic myelocytic leukaemia (CML) have been followed closely during and after development of blastic transformation (BT). Severe fatigue in previously asymptomatic patients was the most frequently observed prodrome of transformation. Most significant clinical findings were anaemia, rapidly increasing WBC and increasing size of the spleen in patients with previously well-controlled CML. 11 out of 24 patients responded to chemotherapy and had a median survival of 3 months, 6 obtained a complete remission (CR). Median survival time for all patients was 2 months from BT. Quality of life after BT was in most cases inferior. Thus, only 5 patients spent more than 1 month outside hospital. Cytomorphological classification of blasts in marrow as granular or agranular showed no correlation to the results of chemotherapy or to survival.