An Unprecedented Case of p190 Chronic Myeloid Leukemia Diagnosed during Treatment for Multiple Myeloma: A Case Report and Review of the Literature.

We report the case of a 76-year-old man who was diagnosed as having chronic myeloid leukemia (CML) with p190 while receiving treatment for symptomatic multiple myeloma (MM). The diagnosis of MM was based on the presence of serum M-protein, abnormal plasma cells in the bone marrow, and lytic bone lesions. The patient achieved a partial response to lenalidomide and dexamethasone treatment. However, 2 years after the diagnosis of MM, the patient developed leukocytosis with granulocytosis, anemia, and thrombocytopenia. Bone marrow examination revealed Philadelphia chromosomes and chimeric p190 mRNA. Fluorescence in situ hybridization also revealed -positive neutrophils in the peripheral blood, which suggested the emergence of CML with p190 . The codevelopment of MM and CML is very rare, and this is the first report describing p190 -type CML coexisting with MM. Moreover, we have reviewed the literature regarding the coexistence of these diseases.