K Itoh, T Kashimura, Y Kobayashi, F Yagasaki, T Sakata, N Kawai, A Matsuda, S Kusumoto, M Fukuda, H Ino, I Murohashi, I Jinnai, S Yoshida, M Bessho, M Saitoh, K Hirashima
A 78-year-old man was diagnosed as leukocytosis in February 1994. Physical examination revealed marked hepatosplenomegaly. A peripheral blood examination disclosed 95,090/microliter leukocytes without hiatus leukemicus, 6.5 g/dl Hb, and 15.0 x 10(4)/microliter platelets. The neutrophil alkaline phosphatase score was 27, and serum VB12 was above 1,600pg/ml. IgG was identified as monoclonal immunoglobulin of type lambda. Bone marrow specimens demonstrated marked granulocytic hyperplasia. Neither the Philadelphia chromosome (Ph1) nor BCR gene rearrangement was detected; hence, the diagnosis of Ph1 (-) chronic myeloid leukemia (CML) was made...
February 1999: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology