Spontaneous Cyclic Leukocytosis and Thrombocytosis in Chronic Granulocytic Leukemia

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Abstract
Spontaneous cyclic fluctuations for both the granulocyte and platelet counts in two patients with chronic granulocytic leukemia were observed over periods of 10 and 14 months. In each patient the length of the cycle was the same for granulocytes and platelets although the phases differed; the cycle was 66 days in one and 56 days in the other. In both the amplitude of each consecutive granulocyte oscillation increased, whereas the nadir remained about the same. The platelet cycles followed the same pattern of increasing amplitude. Using 32P-di-isopropylfluorophosphate during different periods of the cycle, we showed changes in the total blood granulocyte pool with no shift to the marginal pool to account for the fluctuations in white-cell counts. A negative feedback mechanism under the control of some circulating substance that diminishes with time seems the most likely explanation of these data.