Leukocyte drumsticks in chronic granulocytic leukemia and related disorders.

I N PREVIOUS REPORTS we demonstrated that leukocyte alkaline phosphatase and catalase concentrations were altered in leukemia.9’21 In chronic granulocytic leukemia ( CGL), leukocyte alkaline phosphatase is low and catalase is high. These abnormal values return to normal in most patients with CCL in response to treatment. These enzyme changes were noted in the early stages of this disease at times when there were very few immature cells in the peripheral blood. This suggested that there may be two types of neutrophils in CGL, each with similar morphologic but dissimilar biochemical characteristics. In order to explore further the “double cell” population theory in CGL, the “drumstick” of the polymorphonuclear neutrophils was investigated. Davidson and Smith were the first to identify these peculiar nuclear appendages, and to define their relationship to the sex-chromatin of the cells.4 Recent studies on the chromosomes of neoplastic cells from mammalian tumors have demonstrated that these cells have altered chromosomal patterns. It was speculated that these chromosomal aberrations might result in changes in the drumstick count of the granulocytes of patients with CGL which could be detected by means of careful morphologic study.