Chronic myeloid leukemia following repeated diagnostic X-ray exposure for the treatment of recurrent spontaneous pneumothorax in a patient with ankylosing spondylitis: A case report and literature review.

Previous studies have indicated that X-ray irradiation may increase the risk of chronic myeloid leukemia (CML), and the incidence of spontaneous pneumothorax in patients with ankylosing spondylitis (AS) is higher than in the general population. Patients with AS usually develop spontaneous pneumothorax several years after the diagnosis of AS. The present study reports the unusual case and complicated clinical history of a 29-year-old man with recurrent pneumothorax and AS, who developed CML following repeated exposure to low doses of radiation via diagnostic X-rays and chest computed tomography imaging. Pneumothorax was diagnosed prior to AS in this patient; the present case report highlights the importance of recognizing AS as a possible underlying cause of recurrent spontaneous pneumothorax. Patients with AS may be more sensitive to injury via X-ray-derived radiation, and even small diagnostic doses may be associated with CML. Diagnostic X-ray exposure should therefore be limited to reduce the risk of radiation-associated malignancies, including CML, particularly in patients with AS.