Döhle Bodies and Other Granulocytic Alterations during Chemotherapy with Cyclophosphamide

Abstract

Morphologic alterations following cyclophosphamide chemotherapy have been described in 25 patients having different types of malignant disease. Significant findings included: 1) An increased number of Döhle bodies in the granulocytes of untreated patients with cancer. 2) A marked increase in the number of Döhle bodies during therapy, approaching normality during the second and third month following initiation of chemotherapy. 3) A "shift to the left" of nuclear maturation during the initial stages of chemotherapy and a return toward normal in a manner similar to that seen with Döhle bodies. 4) The appearance of coarse cytoplasmic granulation in all leukocytes, and of giant platelets during chemotherapy. The presence of Döhle bodies, nuclear immaturity, "toxic" cytoplasmic granulation, and giant platelets may indicate, at least in some measure, a general metabolic disturbance of the hematopoietic system.