Survival more than 19 years after the diagnosis of accelerated phase of chronic myelocytic leukemia.

In October 1991, a 52-year-old white woman with no significant family or exposure history presented with mid-epigastric abdominal and back pain. Her internist found splenomegaly, and a complete blood count showed a white blood cell count (WBC) of 200,000/μL, a hematocrit of 34%, and a platelet count of 73,000/μL. A computed tomography scan demonstrated hepatosplenomegaly. She was later seen by a hematologist who, after examining a bone marrow aspirate and biopsy, made a diagnosis of CML. Marrow cytogenetics are not available from that time. The patient was started on hydroxyurea 1 g/day, which she received for 2 weeks prior to coming to our center in the end of November 1991 for a second opinion. In the spring of 1990, she had normal routine blood studies, except for a WBC count of 11.5/μL with a normal differential WBC. On initial examination by Dr. Wiernik in December 1991, the patient appeared to be well and was afebrile.