Basophilic Blast crisis of CML- Barely encountered

Abstract

Objective: Chronic leukemias are rare and blastic phase of CML are even rare. Imunophenotyping/IHC  studies have a limited role in the diagnosis of CML  but are  being used in CMl blast transformations. Purpose of this current study was to report the barely encountered basophilic blast crisis of CML .and to determine the clinical and laboratory and Flow immunophenotyping (FIC)/IHC  features  of blast crisis.  Methods: 8 years analysis was done 688 cases of suspected CMI were studied . Patients were evaluated at KMIO between 2004 to 2012. 488 cases had Bone marrow diagnosis of CML. 42 cases peripheral smear was suggestive of blastic phase CML were selectively  chosen for the study. Bone marrow , Karyotyping and  Molecular confirmation was  available .  IHC /FIC was done in  15 cases. Results: adults and Male sex predilection was seen. Gender ratio was 1.6: 1.splenomegaly& Leucocyte count> 200X10° I was seen, in all cases bone marrorw aspiration confirmed the diagnosis,most cases of CML  progressed to blastic phase from chronic phase during their course of treatment. Phildelphia chromosome was noted in most cases.and 6 cases revealed additional markers .PCR revealed p210 transcript in all cases. In 15 cases in the blastic phase Flow cytometry immunophenotype/IHC was done. 9 cases were myeloid blastic phase,2 cases were reported as basophilic blast crisis single case was mixed phenotype, 3 cases were lymphoid blastic phase. Conclusion:  most treated  cases attained remission with imatinib, continue to be in remission after a mean of 8 months.