Jeon Won Jin, Dalal Suhani, Moon Jin Hyun, Joung Bowon, Nguyen Michael, Castillo Dani, Hudson Jessica, Park Kiwon, Raghavan Ravi, Akhtari Mojtaba, Patel Ami
Department of Internal Medicine, School of Medicine, Loma Linda University, Loma Linda, CA, USA.
Division of Medical Oncology/Hematology, Department of Internal Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA.
J Hematol. 2023 Aug;12(4):187-196. doi: 10.14740/jh1150. Epub 2023 Aug 8.
Chronic myelogenous leukemia (CML) is a hematologic malignancy with unique significance to the field of hematology and oncology, specifically due to the development of tyrosine kinase inhibitors (TKIs). CML often presents with nonspecific symptoms, and the quality of life in patients with CML has drastically improved as a result of TKIs. However, complications of CML including the risk of transforming into life-threatening blast crises continue to exist. Further, as most patients are asymptomatic in the chronic phase, patients often present with serious complications associated with noncompliance to TKIs. For example, central nervous system (CNS) manifestations of CML have been reported, both as the initial presentation of undiagnosed CML and as known complication of uncontrolled CML. Hyperleukocytosis is a manifestation of uncontrolled CML and leukostasis is a complication, occurring in cases of acute myeloid leukemia (AML). Here we present a rare case of leukostasis in a patient with known CML presenting on computed tomography (CT) as intracranial masses in the chronic phase. Our goal is to discuss this rare case of leukostasis in adult CML and describe its management.
慢性粒细胞白血病(CML)是一种对血液学和肿瘤学领域具有独特意义的血液系统恶性肿瘤,特别是由于酪氨酸激酶抑制剂(TKIs)的出现。CML通常表现为非特异性症状,并且由于TKIs的应用,CML患者的生活质量有了显著提高。然而,CML的并发症,包括转化为危及生命的急变期的风险仍然存在。此外,由于大多数患者在慢性期无症状,患者常因不遵守TKIs治疗而出现严重并发症。例如,CML的中枢神经系统(CNS)表现已有报道,既作为未确诊CML的初始表现,也作为未控制CML的已知并发症。高白细胞血症是未控制CML的一种表现,而白细胞淤滞是一种并发症,发生于急性髓系白血病(AML)病例中。在此,我们报告一例已知CML患者在慢性期计算机断层扫描(CT)上表现为颅内肿块的罕见白细胞淤滞病例。我们的目的是讨论成人CML中这种罕见的白细胞淤滞病例并描述其治疗方法。