Kartthik S, Mandal Prakas K, Abdullah Saleh Mohammed
Department of Haematology-Oncology, GKNM Hospital, Coimbatore, Tamilnadu, India.
Department of Haematology, NRS Medical College and Hospital, Kolkata, West Bengal, India.
Case Rep Hematol. 2019 Sep 9;2019:5674193. doi: 10.1155/2019/5674193. eCollection 2019.
Chronic myelogenous leukemia (CML) is a clonal myeloproliferative neoplasm (MPN) characterized by dysregulated and uncontrolled proliferation of mature and maturing granulocytes with normal differentiation. A genetic hallmark of CML is the presence of the fusion gene product BCR-ABL. Bleeding diathesis in CML patients is rare (<10%) and primarily caused by acquired platelet dysfunction. We report a rare case of an adult CML chronic phase patient who presented with spontaneous muscle hematoma due to acquired Glanzmann's thrombasthenia (GT). On laboratory workup, a GT was confirmed along with the diagnosis of CML in chronic phase. The muscle hematoma was completely resolved following imatinib therapy. The present case demonstrates that bleeding is a complication of MPNs and highlights the importance of both acquired GT diagnosis to determine the cause of bleeding in CML and of prompt treatment with imatinib to reverse this condition.
慢性粒细胞白血病（CML）是一种克隆性骨髓增殖性肿瘤（MPN），其特征是成熟和正在成熟的粒细胞增殖失调且不受控制，但分化正常。CML的一个基因标志是融合基因产物BCR-ABL的存在。CML患者的出血素质罕见（<10%），主要由获得性血小板功能障碍引起。我们报告了一例罕见的成年CML慢性期患者，该患者因获得性血小板无力症（GT）出现自发性肌肉血肿。实验室检查确诊为GT以及CML慢性期。伊马替尼治疗后肌肉血肿完全消退。本病例表明出血是MPN的一种并发症，并强调了获得性GT诊断对于确定CML出血原因的重要性以及伊马替尼及时治疗以逆转这种情况的重要性。
