mercaptopurine and Osteolysis

Contrarily to what happens in acute leukemia, the incidence of osteolytic lesions in chronic leukemia is exceedingly low. Three patients with chronic myeloid leukemia (CML) who developed such lesions during the chronic phase of their disease form the basis of this report. Osteolytic lesions appearing during the chronic phase of CML are different from those appearing during acute leukemia or during the acute terminal phase of CML, and the differences between both types of osteolysis are briefly reviewed. In the present cases the appearance of osteolytic lesions during the chronic phase of CML preceded for a variable period the terminal acute blastic phase. Therefore this complication must be considered as a sign of poor prognosis as it relates to the subsequent course of the leukemia. Even though other authors advise local radiotherapy as the treatment of choice of osteolytic lesions, only cytostatic therapy was given to the present patients, with good results as it regards the lesions per se.

Topics: Adult; Aged; Bone Neoplasms; Bone Resorption; Busulfan; Female; Humans; Leukemia, Myeloid; Male; Mercaptopurine; Osteolysis; Pipobroman; Prednisone; Prognosis; Radiography; Vincristine