A case of 45, X, -Y, Ph1 chronic granulocytic leukemia in an atomic bomb survivor and a review of the literature

A 60 year-old male was exposed to the atomic bomb approximately 3 km from the hypocenter at age 30. He has 7 children. Leukocytosis and the appearance of immature granulocytes were noted at the time of his cycle examination at the Radiation Effects Research Foundation in August 1975. In November 1975, the diagnosis of chronic granulocytic leukemia was made from the bone marrow aspiration which revealed granulocytic hyperplasia (G/F=6/1), and chromosome analysis of the bone marrow cells showed 45, X, -Y, Ph1 karyotype in 100% of the cells examined. At that time, the spleen was palpable 2 finger breadths below the left costal margin. Peripheral blood findings were as follows: RBC, 348 x 104; Hgb, 10.8 g/dl; Hct, 33.5%; platelets, 295,000; and WBC, 83,500 (differential; Pro 1.5, Myelo 12.5, Meta 11.0, Stab 9.5, Seg 44.5, Ly 10.5, Mono 7.0, Eos 1.5, Baso 2.0). The neutrophile alkaline phosphatase was normal (rate 60, score 260). The leukocyte count decreased markedly after busulfan administration. 19 months after the diagnosis, his clinical course is satisfactory and there are no findings suggestive of blastic crisis. (auth.)