Juvenile and adult types of chronic granulocytic leukemia of childhood: Growth patterns and characteristics of granulocyte‐macrophage colony forming cells

Peripheral blood and bone marrow cells from three children with the juvenile (Ph¹ negative) type of chronic granulocytic leukemia and from one with the adult (Ph¹ positive) type were cultured in soft agar, and their specific growth patterns were evaluated. Greatly increased numbers of colonies were obtained in all cases, particularly from peripheral blood cells. By morphologic, cytochemical and ultrastructural criteria, colonies from one juvenile type and from the single adult type patients were found to be almost exclusively granulocytic, whereas in the other two juvenile type leukemia patients colonies were either granulocytic or macrophage. Moreover, both growth patterns were obtained in the same patients on different occasions. It appears that the leukemic cell populations of the juvenile and the adult forms of chronic granulocytic leukemia do not arise from different cell lines. Rather, both are the progeny of the common monocyte‐granulocyte progenitor cell, whose abnormal proliferation and differentiation along either the granulocytic or the monocytic pathway is probably directed by fluctuations in humoral and/or microenvironmental factors.