Erythropoiesis during an erythroblastic transformation of chronic myelocytic leukemia

✍ Scribed by Ronald Hoffman; Nicholas Dainiak; Victoria Floyd; A. Kim Ritchey; Eric Mazur

• Publisher: John Wiley and Sons
• Year: 1981
• Tongue: English
• Weight: 402 KB
• Volume: 47
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19810215)47:4<720::aid-cncr2820470416>3.0.co;2-h

✦ Synopsis

The requirements of erythropoiesis for erythropoietin were studied in a patient with Ph' chronic myelocytic leukemia who had undergone an erythroblastic transformation. Transfusions resulted in a suppression of erythropoiesis. Plasma clot culture studies indicated that both the CFU-E and BFU-E in the peripheral blood of this patient were dependent upon erythropoietin for their differentiation and proliferation. Neither of these committed erythroid stem cells was cloned in the absence of erythropoietin. These studies suggest that the proliferation and differentiation of erythroid stem cells during the erythroblastic crisis of this disorder remain dependent upon physiologic regulators.

Cancer 47:720-723, 1981.

H E M A J O R I T Y OF CASES of chronic myelocytic leu-

T kemia (CML) terminate in a blastic transformation which clinically and morphologically resembles de t i o v o acute myeloblastic leukemia.' Recent morphologic, cytochemical, biochemical, and immunologic studies indicate that the terminal phase of C M L is a heterogeneous event. In addition to the classical myeloblastic proliferation, l y m p h ~b l a s t i c , " ~ e r y t h r ~b l a s t i c , ~ and megakaryoblasticj transformations have been described.

Erythropoietin ( E p ) is considered t o be the primary regulator of erythrocyte production in man.'j It has been suggested that some types of neoplastic erythroid proliferation might be autonomous of E p r e g ~l a t i o n . ~ Srodes et ul. studied two patients with the rare erythroblastic crisis of C M L and failed to observe decreased erythroid activity with hypertransfusion.' These workers have suggested that erythropoiesis is autonomous of normal control mechanisms in this rare syndrome.

This investigation was undertaken t o better characterize erythropoiesis in the erythroblastic crisis of C M L using both in vitro and in i9iw methods to determine