1. Three adults with CML, 2 Ph1 chromosomes, and marked peripheral lymphadenopathy are described.

2. In each instance node enlargement was thought to be due to leukemic infiltration rather than a supervenient lymphomatous process.

3. Marked adenopathy is an unfavorable prognostic sign in CML, particularly if caused by myeloblastic infiltration. Such infiltration can precede myeloblastic involvement of the peripheral blood and bone marrow.

4. Karyotype analysis and touch preparations of extramedullary tumor tissue in CML will aid in accurate diagnosis and may help to answer more basic questions regarding the pathogenesis of this malignancy.

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