만성골수성 백혈병의 임상적 고찰

Abstract

A retrospective review is presented for 23 previously untreated patients with chronic myelogenous leukemia between July 1981 through July 1987 at the Keimyung University. The results of study were as follows: The mean age was 38 years with a male to female ratio of 1.1:1. On admission, LUQ mass was the most frequent complaint in 12 cases (52.2%) and easy fatigability, general weakness, bleeding, indigestion, weight loss were commonly presented on order of frequency. Physical finding revealed splenomegaly in all case, hepatomegaly in 10 cases(43.5%), and lymphadenopathy in 2 cases(8.7%). Hematologic finding revealed hematocrit below 11.9gm/dl in 87% with mean of 9.0(range: 5.1-14.0)gm/dl, leukocyte over 100,000/mm³ in 87% with mean of 241,200(range; 46,500--516,500)/mm³, and platelet over 800,000/mm³ in 22% with mean of 522,000(range: 170,000-1,112,000)/mm³. Bone marrow aspiration disclosed mean percentage of myeloblast was 3.5% and mean of myeloblast plus promyelocyte was 10.9%. Peripheral leukocytosis was deeply correlated with bone marrow immature cells(p<0.001), but did not relate to spleen size, degree of anemia, peripheral immature cells, and LDH(p,0.01). Cytogenetic study was performed in 10 cases, and there was Philadelphia chromosome in 6 cases, aneuploidy and double minute chromosome in one case, and normal study in 3 case, and one which performed in blastic phase revealed Ph¹, 8 trisomy, and I (17q). Three year survival rate of total 23 cases of busulfan-treated patient is 80% with mean survival time of 42 months, and there was no statistical significance between male and female group(p<0.1).