Extensive Bone Lesions and Skin Lesions Revealing an Acute Transformation of an Extramedullary Chronic Myeloid Leukemia
Cancer Research Journal
Volume 6, Issue 2, June 2018, Pages: 70-73
Received: Mar. 13, 2018;
Accepted: Mar. 29, 2018;
Published: May 5, 2018
Views 1647 Downloads 81
Bienvenu Houssou, Department of Clinical Hematology and Pediatric Oncology, Hospital August 20th 1953, University Hassan II, Casablanca, Morocco
Mouna Lamchahab, Department of Clinical Hematology and Pediatric Oncology, Hospital August 20th 1953, University Hassan II, Casablanca, Morocco
Halima Hadri, Department of Clinical Hematology and Pediatric Oncology, Hospital August 20th 1953, University Hassan II, Casablanca, Morocco
Boubker Messoudi, Department of Trauma and Orthopedic of the Hospital Ibn Rochd, University Hassan II, Casablanca, Morocco
Abdeljabbar Messoudi, Department of Trauma and Orthopedic of the Hospital Ibn Rochd, University Hassan II, Casablanca, Morocco
Asma Quessar, Department of Clinical Hematology and Pediatric Oncology, Hospital August 20th 1953, University Hassan II, Casablanca, Morocco
Follow on us
Extramedullary blast transformation as the initial presentation of Chronic Myeloid Leukemia with bone marrow remaining in the chronic phase is an unusual event. We report the case of a 30-year-old with chronic CML at the medullary level and an acute transformation revealed by extensive bone lyses and skin lesions. A 30-year-old man had cutaneous nodules, functional impotence and paresis. Radiological investigations revealed osteolytic lesions of the right humeral head, right clavicle, ribs, C5 and C7 vertebrae with medullary compression. Anatomo-pathological study and immunohistochemistry of nodules and osteolytic lesions resulted in granulocytic sarcoma with CD10 +, CD34 +, CD13 +, CD33 +, CD117 and MPO positive. The myelogram was in favor of chronic phase CML. He was put on imatinib, the chemotherapy could not be started because his condition was impaired and he dies by metabolic disorder. The acute transformation of chronic phase CML into extra marrow remains unusual. The care is a real challenge hence the need for consensual recommendations.
Acute Transformation, Chronic Myeloid Leukemia, Bones lesions, Skin Lesions
To cite this article
Extensive Bone Lesions and Skin Lesions Revealing an Acute Transformation of an Extramedullary Chronic Myeloid Leukemia, Cancer Research Journal.
Vol. 6, No. 2,
2018, pp. 70-73.
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Jin GN, Zou P, Chen WX, Ding ZY, Zhou H. Fluorescent in situ hybridization diagnosis of extramedullary nodal blast crisis. Diagn Cytopathol. 2013; 41 (4):253–256.
Shune L, Cayci Z, Rogosheske J, Brunstein C, Ustun C. Extramedullary blastic crisis in abdominal lymph nodes in a patient with chronic myelogenous leukemia on imatinib. Leuk Res. 2012; 36 (6):e131–e132.
Gao X, Li J, Wang L, Lin J, Jin H, Xu Y, Wang N, et al. Bilineal Extramedullary Blast Crisis as an Initial Presentation of Chronic Myeloid Leukemia: A Case Report and Literature Review. Am J Case Rep. 2016: 27; 17:793-798.
Levy RA, Mardones MA, Burch MM, Krause JR. Myeloid sarcoma as the presenting symptom of chronic myelogenous leukemia blast crisis. Proc (Bayl Univ Med Cent) 2014; 27 (3):246–49.
Kantarjan HM, Keating MJ, Talpaz M. Chronic myelogenous leukemia in blast crisis: analysis of 242 patients. Am J Med. 1987; 83:445–454.
Canellos G. Clinical characteristics of the blast phase of chronic granulocytic leukemia. Hematol Oncol Clin North Am. 1990; 4:359–376.
Specchia G, Palumbo G, Pastore D, Mininni D, Mestice A, Liso V. Extramedullary blast crises in chronic myeloid leukemia. Leuk Res. 1996; 20:905–908.
O'Hare T, Walters DK, Stoffregen EP, Jia T, Manley PW, Mestan J, et al. In vitro activity of Bcr-Abl inhibitors AMN107 and BMS-354825 against clinically relevant imatinib-resistant Abl kinase domain mutants. Cancer Res. 2005; 65 (11):4500–4505.
Porkka K, Koskenvesa P, Lundan T, Rimpilainen J, Mustjoki S, Smykla R, et al. Dasatinib crosses the blood-brain barrier and is an efficient the therapy for central nervous system Philadelphia chromosome-positive leukemia. Blood. 2008; 112 (4):1005–1012.
Yu HH, Lu MY, Lin DT, Lin KH, Tang JL, Jou ST. Pathological fracture as a manifestation of extramedullary blastic crisis in chronic myelogenous leukemia: report of one case. Acta Paediatr Taiwan. 2006; 47 (3):150–154.