Membrane Marker Analysis of ‘Lymphoid’ and Myeloid Blast Crisis in PH1 Positive (Chronic Myeloid) Leukemia

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Abstract
In addition to its diagnostic application, the Ph1 chromosome has been used as a clonal marker for analysing haemopoietic stem cell development in man (8, 29). During these clinical studies it has become evident that the clinical presentation and course of CML is heterogeneous (reviewed in refs. 24, 3, 1). The disease often progresses into myeloid blast crisis (which resembles acute myeloid leukaemia, AML) and sometimes progresses into ‘lymphoid’ blast crisis (which resembles acute lymphoid leukaemia, ALL). It has also been observed recently that some Ph1 positive patients with ‘lymphoid’ involvement present in ‘lymphoid’ blast crisis and thus simulate common ALL (20, 1, 15), but the development of obvious myeloid involvement in these patients is also frequent (20, 15). Thus, this particular clinical syndrome with morphologically dissimilar leukaemic populations in the patient (which nevertheless carry the same clonal marker, the Ph1 chromosome) offers unique possibilities to analyse the interrelationship of lymphoid and myeloid leukaemias and their respective normal target cells.