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January 1983

Smoldering Acute Granulocytic Leukemia: Observations on Its Natural History and Morphologic Characteristics

Author Affiliations

From the Department of Medicine, Division of Hematology (Drs Van Slyck and Janakiraman), and the Department of Pathology (Dr Rebuck), Henry Ford Hospital, Detroit; and the Section of Hematology, Veterans Administration Center, Houston (Dr Waddell).

Arch Intern Med. 1983;143(1):37-40. doi:10.1001/archinte.1983.00350010039008

• In this prospective study, 24 patients with smoldering acute granulocytic leukemia received no specific treatment. Median survival duration from diagnosis was 9.29 months. Fourteen patients died of infection, four died of hemorrhage, two (8%) progressed to aggressive acute leukemia, and three remain alive at 36, 32, and 10 months. No survival predictions could be made from the severity of leukopenia, thrombocytopenia, or both. Neither sepsis nor hemorrhage, as causes of death, segregated into short- or long-term survivors (9.0 and 8.75 months' median survival, respectively). Thirteen patients (59%) had French, American, and British M2 subclassification of acute granulocytic leukemia. The following marrow findings distinguished this entity from preleukemia and other dysplastic states: clustering of stem cells; presence of micromyeloblasts; myeloblast differential percentage usually between 20% and 40%; and Auer rods. The use of aggressive chemotherapy v only supportive measures in this condition remains unsolved.

(Arch Intern Med 1983;143:37-40)

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