PREMATURE CHROMOSOME CONDENSATION STUDIES IN HUMAN-LEUKEMIA .1. PRETREATMENT CHARACTERISTICS

Abstract

The phenomenon of premature chromosome condensation (PCC) was used to compare the bone marrow proliferation characteristics of 163 patients with various forms of leukemia prior to the initiation of new therapy. The proliferative potential index (PPI, or fraction of G1 cells in late G1 phase) and the fraction of cells in S phase was determined and compared to the type of disease and the bone marrow blast infiltrate for each patient. Previously untreated patients with acute leukemia exhibited an average PPI value 3 times that of normal bone marrow (37.5% for acute myeloblastic leukemia [AML], acute mono-myeloblastic leukemia [AMML] or acute promyelocytic leukemia [APML] and 42% for acute lymphocytic leukemia [ALL] or acute undifferentiated leukemia [AUL]). Untreated chronic myelogenous leukemia (CML) patients showed intermediate PPI values (25.2%), whereas CML patients with controlled disease exhibited nearly normal PPI values (14.6%). Blastic-phase CML patients exhibited PPI values closer to that observed in patients with acute leukemia (35.4%). Seven patients with chronic lymphocytic leukemia (CLL) exhibited even higher PPI values. No correlations were observed between PPI values, fraction of cells in S phase and marrow blast infiltrate. For untreated acute disease patients, PPI values were prognostic for response only at low and high PPI values. The PCC-determined proliferative potential apparently is a biologic reflection of the degree of malignancy within the bone marrow.