Abstract

In a recent comprehensive review, it was concluded that agnogenic myeloid metaplasia is not related to chronic myelogenous leukemia.' It was stated that separation of these two disorders by standard clinical and laboratory methods is relatively easy in the majority of cases, and in the few difficult cases determination of the level of leukocyte alkaline phosphatase, level of serum vitamin B12, chromosome analysis and tissue biopsy provide the appropriate diagnosis. Previous reports of transitional cases of agnogenic myeloid metaplasia and chronic myelogenous leukemia were reviewed and classified as unproved. Furthermore, after reviewing the reported cases of Philadelphia chromosome-positive agnogenic myeloid metaplasia, it was concluded that the diagnosis was doubtful in all these cases, and that the Philadelphia chromosome appears to be specific for chronic myelogenous leukemia.The purpose of this case report is to present a myeloproliferative disorder which meets the criteria for both chronic myelogenous leukemia and advanced myeloid metaplasia.