Gajendra Smeeta, Sharma Archana, Sharma Rashi, Gupta Sunil Kumar, Sood Nitin, Sachdev Ritesh
Department of Pathology & Laboratory Medicine, Medanta the Medicity, GURGAON, INDIA.
Turk Patoloji Derg. 2019;35(1):74-78. doi: 10.5146/tjpath.2016.01368.
Chronic myeloid leukemia (CML) is characterized by increased and unregulated proliferation of granulocytic lineage in the bone marrow and presence of these immature myeloid cells in the peripheral blood with presence of Philadelphia (Ph) chromosome. Tyrosine kinase inhibitors are the most important drugs in the CML therapy and provide long disease-free survival. Due to the increased survival of CML patients with continual administration of these drugs, the chance of development of secondary malignancies may increase. The most common secondary malignancies are prostate, colorectal and lung cancer, non-Hodgkin lymphoma, malignant melanoma, non-melanoma skin tumors and breast cancer. Herein, we are describing a rare case of Hodgkin lymphoma in a patient of CML after ten year of primary disease presentation. Hodgkin lymphoma in a known case of CML is very rare and further studies are also needed to know the pathogenic relationship between the two entities and to assess the risk of secondary Hodgkin lymphoma in CML patients treated with tyrosine kinase inhibitors. CML itself is a risk factor for development of solid cancers and hematologic malignancies. In addition, patients on chemotherapy are immune-compromised and may be at greater risk of neoplasm driven by infectious agents such as Epstein-Barr virus.
慢性髓性白血病（CML）的特征是骨髓中粒细胞系增殖增加且不受调控，外周血中存在这些未成熟髓细胞，并伴有费城（Ph）染色体。酪氨酸激酶抑制剂是CML治疗中最重要的药物，可实现长期无病生存。由于持续使用这些药物使CML患者的生存期延长，发生继发性恶性肿瘤的可能性可能增加。最常见的继发性恶性肿瘤是前列腺癌、结直肠癌和肺癌、非霍奇金淋巴瘤、恶性黑色素瘤、非黑色素瘤皮肤肿瘤和乳腺癌。在此，我们描述了1例原发性疾病出现10年后发生霍奇金淋巴瘤的CML患者。已知CML病例中发生霍奇金淋巴瘤非常罕见，还需要进一步研究以了解这两种疾病之间的致病关系，并评估接受酪氨酸激酶抑制剂治疗的CML患者发生继发性霍奇金淋巴瘤的风险。CML本身就是发生实体癌和血液系统恶性肿瘤的危险因素。此外，接受化疗的患者免疫功能受损，可能更易发生由诸如爱泼斯坦-巴尔病毒等感染因子引发的肿瘤。
