Manifestation Of Chronic Myeloid Leukemia Research Articles

Bilateral proliferative retinopathy with blood-tinged hypopyon as the first manifestation of chronic myeloid leukemia

Bilateral proliferative retinopathy with blood-tinged hypopyon as the first manifestation of chronic myeloid leukemia

Priapism as the first symptom of chronic myeloid leukemia: literature review and own clinical case report

Chronic myeloid leukemia is a ph-positive myeloproliferative disease, which is usually manifested by hyperleukocytosis and massive splenomegaly. Chronic myeloid leukemia is rare in childhood and adolescence, it accounts for 2 to 3 % of all leukemias cases. priapism is a rare manifestation of chronic myeloid leukemia and is an urgent urological condition that requires timely treatment to prevent long-term complications, in particular, erectile dysfunction.This review presents the literature information about priapism as the first sign of chronic myeloid leukemia, as well as the first description in the Russian literature of a clinical case of priapism in a 9-year-old patient with chronic myeloid leukemia.

Trunk's Papules, and If It was a Leukemia Cutis

Leukemia cutis characteristically demonstrates the infiltration of the skin by neoplastic leukocytes [1]. In clinical practice, the most common types seen are chronic lymphocytic leukemia (CLL) and acute myeloid leukemia (AML) often in patients who have a prior diagnosis of systemic leukemia [2]. However, cutaneous lesions may present as the primary manifestation of chronic myeloid leukemia (CML) in rare cases. It is generally synonymous of advanced disease and must encourage the search of other extramedullary sites involvement [3,4].

PRIAPISM AS THE FIRST SIGN OF CHRONIC MYELOID LEUKEMIA

Introduction. Priapism is a prolonged painful erection lasting for more than four hours, which either persists after the termination of sexual stimulation or is not associated therewith. Priapism may be the first clinical manifestation of chronic myeloid leukemia (CML).Aim. To describe a clinical case of ischemic priapism that occurred in a patient with a previously undiagnosed CML.General findings. We present a clinical observation of ischemic priapism having lasted for 18 hours, which occurred in a patient with a previously undiagnosed CML. The diagnosis of CML was subsequently established on the basis of a study of peripheral blood and bone marrow. The therapeutic tactics consisted in an immediate puncture aspiration of blood from the corpora cavernosa and an intracavernous injection of a phenylephrine solution. After priapism had been relieved, an CML therapy was applied, which allowed the recurrence of priapism in the patient to be avoided.

Ischemic priapism as the first manifestation of chronic myeloid leukemia

Priapism may occur in patients with hematological disorders with excessive white blood cell counts, such as chronic myeloid leukemia (CML). Priapism may be the first clinical manifestation of CML. At this work we report a case of a young adult who presented with ischemic (low-flow or veno-occlusive) priapism which had persisted for the last 18 hours as the first manifestation of CML. CML was diagnosed on the basis of peripheral blood and bone marrow examination . Treatment of the priapism was initiated by corporal aspiration and intracavernous phenylephrine irrigation. Furthermore, along with management of priapism, appropriate treatment of CML allows to reduce risk of recurrence of priapism in this patient.

Simultaneous Bilateral Central Retinal Vein Occlusion as the First Manifestation of Chronic Myeloid Leukemia

Simultaneous Bilateral Central Retinal Vein Occlusion as the First Manifestation of Chronic Myeloid Leukemia

Ischemic priapism: A rare clinical manifestation of chronic myeloid leukemia - A Case Report

<p>Priapism is rarely seen in leukemia. We report a 30-year-old man presented with persistent painful erection of penis for 30 hours. Treatment of the priapism was initially performed by cavernosa aspiration and epinephrine irrigation at emergency department under the impression of low flow-type priapism by urologist. This approach resulted in a flaccid penis later. The patient was diagnosed as a case of Chronic myeloid Leukemia (CML) on the basis of peripheral blood smear and bone marrow aspiration. Neither impotency nor other sequelae was noted after his discharge from the hospital. This case highlights regarding the awareness of all physicians in the diagnosis and management of patients with priapism occurring as a rare manifestation of chronic myeloid leukemia. To the best of our knowledge, probably this is the first case report from this part of the country, hence the case report.</p><p id="tinymce" class="mceContentBody " dir="ltr">Bangladesh Journal of Medical Science Vol.15(1) 2016 p.142-144</p>

A Case of a Child with Chronic Myeloid Leukemia Presenting with Vision and Hearing Loss

Chronic myeloid leukemia (CML) is a relatively rare malignancy of cells of the hematopoietic system. Loss of vision and hearing is a very rare presenting manifestation of CML especially at a young age. We are reporting a rare case of CML in 16 years old male presenting with loss of hearing and vision in Muhimbili National Hospital in Tanzania. This case shows how the non-communicable disease can cause morbidity in children in a developing world and the importance of early diagnosis and management of CML in prognosis. In addition the case shows how adequate investigations and documentation is important in follow up of the patient clinical conditions and treatment outcomes. The patient was put on Tabs Alluprinol 300mg once daily for one month and Tabs hydroxyl urea (HU) 3g once daily for one month. 2 weeks later the child was reported to have confusion, being overactive and over talkative for 3 days prior to attending the scheduled hematology clinic. Complete Blood Count showed a marked decrease in White blood cells. With the rapid patient’s clinical deterioration after initiation of HU, indicates that detailed medical investigations is crucial in disease management and the use of Tyrosine Kinase inhibitors should be encouraged as it has shown to be more tolerated and better survival outcomes in treatment of CML.

Thoracic t(9;22)-Positive Granulocytic Sarcoma as Initial Presentation of Chronic Myeloid Leukemia

Granulocytic sarcoma (GS) is a rare type of soft tissue tumor consisting of myeloid immature cells and blasts that can occur at extramedullary sites. GS is an uncommon manifestation of acute myeloid leukemia (AML), but it can also occur in patients with other myeloid disorders such as chronic myeloid leukemia (CML). Nonetheless, it is very rare for a thoracic GS to be the first manifestation of CML. In this report, we describe a patient with CML who presented with a t(9;22)(BCR-ABL)+ thoracic GS. Interestingly, despite peripheral blood neutrophilic leukocytosis, both peripheral blood and bone marrow (BM) were morphologically and phenotypically normal despite exhibiting the t(9;22) translocation. With a combination of chemotherapy and nilotinib, the patient achieved a major molecular remission.

Spontaneous acute subdural hematoma as the initial manifestation of chronic myeloid leukemia

Spontaneous acute subdural hematoma is rare and limited to sporadic case reports, associated with neoplasm, aneurysm, arteriovenous malformation and cocaine use. Subdural hematoma has also been reported in association with leukemic malignancies, either during therapy or after diagnosis. However, there are no reports of spontaneous acute subdural hematoma as the primary initial presenting manifestation of a chronic myeloid leukemia. Here we describe one case of a 53-year-old male that presented with severe right-sided headache and intermittent left-sided paresthesias. CT scan showed non-traumatic right-sided acute subdural hematoma. Further evaluation revealed that the patient had chronic myeloid leukemia. His peripheral white blood count normalized after Gleevec and hydroxyurea chemotherapy. Furthermore, he had no neurological deficits after his subdural collection was adequately evacuated.

Priapism as the first manifestation of chronic myeloid leukemia

lettersPriapism as the first manifestation of chronic myeloid leukemia Ilias Tazi Ilias Tazi From the Department of Medicine, Hematology Unit, Centre Hospitalier Regional, Beni-Mellal, Morocco Search for more papers by this author Published Online::1 Oct 2009https://doi.org/10.4103/0256-4947.55176SectionsPDF ToolsAdd to favoritesDownload citationTrack citations ShareShare onFacebookTwitterLinked InRedditEmail AboutIntroductionTo The Editor: A previously healthy 33-year-old Moroccan man was referred to the local hospital for persistent painful erection of the penis that had lasted approximately 22 hours. His penis remained erect, painful, and swollen when he arrived at the emergency department. He denied recent intercourse, trauma, use of illicit drugs, use of medications, and radiation therapy. The patient also denied fever, sweats, and chills. The vital signs revealed a body temperature of 37.4 °C, pulse of 98 beats/minute, and blood pressure of 12/7 mm Hg, and respiration of 22 beats/minute. He was alert and oriented. The physical examination revealed that the spleen was palpable 4 cm below the left costal margin. His conjunctiva was pale but no jaundice. On examination, the penis was erect, firm, and tender with superficial venous engorgement. Urinalysis was normal. Laboratory data showed hemoglobin 10.53 g/dL, hematocrit 24%, white blood count 400000/mm3, and platelets 1200000/mm3. A peripheral blood smear demonstrated immature leukocytes in various stages of differentiation. Karyotype analysis revealed the Ph1 chromosome and myeloid hyperplasia in the bone marrow. A diagnosis of chronic myeloid leukemia (CML) was made. Treatment of the priapism was initially performed by cavernosa aspiration and epinephrine irrigation at emergency department under the impression of low flow-type priapism. The erection was relieved later by these procedures. For hyperleukocytosis, the patient was admitted to the hematological ward. He was started on hydroxyurea therapy (50 mg/kg/day) associated with intravenous fluid hydration and allopurinol (300 mg/day) for potential tumor lysis syndrome. After 15 days of chemotherapy with hydroxyurea, the patient's leukocyte and platelet counts were 8000/mm3 and 240000/mm3, respectively. Recurrent priapism had not happened to him during his admission period. The patient was treated with imatinib mesylate for his CML and continued to report to us without any erectile dysfunction until the date of writing.Priapism is a rare disease, characterized by prolonged, painful and irreducible erection, not resulting in ejaculation. It is an andrological emergency with a poor prognosis, as the risk of impotence is 50% despite appropriate management. Sickle cell anaemia, chronic myelogenous leukemia, chronic lymphocytic leukemia, and acute lymphoblastic leukemia are hematologic disorders that can be a cause of priapism.1 In adult leukemic patients, the incidence of priapism is estimated to be approximately 5%.2 Priapism as a result of hematologic malignancy is most likely caused by venous obstruction from microemboli/thrombi as well as hyperviscosity caused by the increased number of circulating leukocytes in mature and immature forms.3 In cases of hematologic malignancy, controversy has existed regarding the optimal treatment of leukemic priapism. Earlier series of case reports show successful detumescence with local radiation therapy, open surgical shunting, or combination of the two treatments.4 More recent literature has focused on the use of cytoreductive modalities such as chemotherapy or combination chemotherapy and leukapheresis.5 Because of the relatively rare occurrence of leukemic priapism and the small number of case series, there is no standard treatment protocol. Chemotherapy or radiotherapy may first be attempted. If detumescence is not achieved, then surgical shunting should be considered.ARTICLE REFERENCES:1. Schreibman SM, Gee TS, Grabstald H. "Management of priapism in patients with chronic granulocytic leukemia" . J Urol. 197406 111(6):786-8. Google Scholar2. Allué López M, García de Jalón Martínez A, Pascual Regueiro D, Mallén Mateo E, Villanueva Benedicto A, Rioja Sanz LA. "[Priapism as an initial presentation of chronic myeloid leukaemia]" . Actas Urol Esp. 200405 28(5):387-9. Google Scholar3. Mulhall JP, Honig SC. "Priapism: etiology and management" . Acad Emerg Med. 199608 3(8):810-6. Google Scholar4. Winter CC, McDowell G. "Experience with 105 patients with priapism: update review of all aspects" . J Urol. 198811 140(5):3. Google Scholar5. Kumar L, Sagar TG, Majhi U, Shanta V. "Priapism in leukaemia-report of three cases" . J Assoc Physicians India. 199003 38(3):229-30. Google Scholar Previous article Next article FiguresReferencesRelatedDetails Volume 29, Issue 5Sep–Oct 2009 Metrics History Published online1 October 2009 InformationCopyright © 2009, Annals of Saudi MedicineThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.PDF download

Priapism as the First Manifestation of Chronic Myeloid leukemia

Priapism as the First Manifestation of Chronic Myeloid leukemia

Megakaryocytic blast crisis as a presenting manifestation of chronic myeloid leukemia

Acute megakaryocytic leukemia is a rare form of acute myelogenous leukemia and may occur either de novo or by transformation of a preexisting myelodysplastic or myeloproliferative process including blast crisis of chronic myeloid leukemia (CML). Megakaryocytic blast crisis as the presenting manifestation of CML is extremely rare. We describe such a patient with no prior hematologic disease who presented with acute megakaryoblastic leukemia and extramedullary involvement, in whom the leukemic cells carried the BCR-ABL1 translocation as part of a complex karyotype. Using targeted sequential fluorescence in situ hybridization (T-FISH) technique, we detected two copies of BCR-ABL1 fusion gene in the leukemic blasts while the neutrophils carried a single copy of BCR-ABL1 fusion gene, thereby proving the origin of the megakaryoblastic leukemia from a previously undiagnosed CML clone. Blast crisis as a presenting manifestation of CML is rare and detecting clonal evolution of acute leukemia by specialized cytogenetic techniques may have important diagnostic and therapeutic implications.

A Pilot Trial of Imatinib, Low-Dose Cytarabine (ara-C) and Idarubicin (Ida) in Patients (pts) with Chronic Myeloid Leukemia (CML) in Myeloid Blastic Phase (BP).

Abstract Although imatinib is the single most effective agent in CML BP, only approximately 30% to 50% of pts achieve a hematologic response, and it is complete (CHR) and durable in 5% or less. Regimens including high-dose ara-C and daunorubicin are associated with remission rates of 20% to 25% in CML BP, a median survival of 3 months, and significant morbidities. Imatinib is additive or synergistic in vitro with ida and ara-C, particularly in imatinib-resistant cell lines. We thus investigated the efficacy of the combination of imatinib 600 mg daily, ara-C 10 mg daily subcutaneous, and Ida 12 mg/m2 IV every 14 days in pts with CML in myeloid BP. Nineteen pts were treated, including 6 who had BP as their first manifestation of CML. Seventeen pts had failed prior imatinib as a single agent and had received a median of 5 prior therapies (range, 1 to 9). Median age was 54 yrs (range, 27–81) and the median WBC was 28.6 x 109/L (range, 3.7 to 240.5), peripheral blood blasts 18% (range, 0 to 82), and bone marrow blasts 36% (range, 2 to 84). Four pts had extramedullary disease. Pts were treated for a median of 10.5 weeks (range, 4 to 124), receiving a median of 2 cycles (range 1 to 28). Fourteen (74%) pts responded, including 9 (47%) who achieved CHR, and 5 (26%) who returned to chronic phase. Four of the pts who achieved CHR also had a cytogenetic response (CGR) (3 complete, 1 minor). Responses lasted for a median of 10 weeks (range, 2 to 89 weeks). Two of 5 pts who failed to respond had a transient hematological improvement (>50% reduction of blasts in peripheral blood). Six pts were able to receive allogeneic BMT (4 in CHR, 1 in CP and 1 still in BP). Treatment was well tolerated and administered on an outpatient basis. Grade 3–4 non-hematological toxicities consisted of fatigue (n=4), vomiting (n=1), bone pain (n=1) and hyperbilirubinemia (n=1). Sixteen (84%) pts required brief hospitalization for neutropenic fever (n=8), bleeding (n=7), pneumonia (n=6), cellulitis (n=2) and CNS disease (n=2). Thirteen pts died: 4 after BMT and 9 due to disease progression. Among these, 4 had achieved CHR and 2 complete CGR. The median survival was 23 wks and 1 year survival rate 26%. In conclusion, the combination with imatinib + low-dose ara-C + Ida is an outpatient, well tolerated regimen that can induce responses in patients with CML BP who have failed imatinib and can be considered as an option to improve patient’s condition, and as a bridge to allogeneic BMT.

Unilateral sudden hearing loss as a presenting manifestation of chronic myeloid leukemia: case report

Unilateral sudden hearing loss as a presenting manifestation of chronic myeloid leukemia: case report

Blast crisis as an initial or terminal manifestation of chronic myeloid leukemia. A study of 28 patients : Peterson LAC, Bloomfield CD, Brunning RD: Am J Med 60: 209–220, 1976

Blast crisis as an initial or terminal manifestation of chronic myeloid leukemia. A study of 28 patients : Peterson LAC, Bloomfield CD, Brunning RD: Am J Med 60: 209–220, 1976

Blast crisis as an initial or terminal manifestation of chronic myeloid leukemia: A study of 28 patients

The clinical and morphologic features of nine patients who initially presented with blastic leukemia and the Philadelphia chromosome were studied. Corresponding features were evaluated at the time of diagnosis of blast crisis in 19 patients who had a previous history of chronic myeloid leukemia (CML). Although many of the presenting symptoms and signs were similar, infections, lymphadenopathy, tissue infiltration and central nervous system involvement were more common in patients who presented with blastic leukemia. Marked leukocytosis, basophilia and marrow hypercellularity were present in both groups. Although patients in both groups had morphologic patterns that resembled acute leukemia, cytology suggestive of acute lymphocytic leukemia was more frequent in patients who initially presented with blastic leukemia. Megakaryocyte, platelet and erythroid abnormalities were more frequent in patients with a prior history of CML. Although there were clinical and morphologic features in the patients who presented with blastic leukemia which suggested the diagnosis of CML in blast crisis, chromosome studies were necessary to identify some of these patients. In both groups of patients multiple therapeutic regimens were used. Complete remissions were obtained in two patients; both presented with blastic leukemia, had “lymphoblastic” morphology and were treated with chemotherapeutic agents generally used for the treatment of acute lymphocytic leukemia. It appears that morphology of the blast crisis may be important in choosing the treatment regimen.