Aziz Afia, Alshurafa Awni, Yassin Mohammad
Department of Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
Department of Hematology, National Cancer Center of Care and Research, Hamad Medical Corporation, Doha, Qatar.
Case Rep Oncol. 2025 May 20;18(1):751-755. doi: 10.1159/000546368. eCollection 2025 Jan-Dec.
Chronic myeloid leukemia is a myeloproliferative disorder characterized by the uncontrolled proliferation of mature and maturing granulocytes in the bone marrow, along with the presence of the Philadelphia chromosome. Lymphadenopathy is an uncommon initial manifestation of CML and is typically attributed to the disease itself. However, with the use of tyrosine kinase inhibitors (TKIs), which can affect T-cell-mediated immunity, new or persistent lymphadenopathy in CML patients warrants investigation to rule out opportunistic infections, including tuberculosis (TB), or progression to the blast phase of CML.
A 35-year-old male diagnosed with chronic-phase CML initially presented with cervical lymphadenopathy. The lymphadenopathy was initially attributed to CML. Further evaluation, including a lymph node biopsy, revealed concurrent TB infection. Treatment with appropriate anti-tuberculous therapy led to the resolution of the lymphadenopathy.
This case highlights the importance of considering opportunistic infections, such as TB, in CML patients presenting with lymphadenopathy, particularly those on TKI therapy. Prompt investigation and appropriate management are crucial to avoid complications and ensure optimal patient outcomes.
慢性髓性白血病是一种骨髓增殖性疾病，其特征为骨髓中成熟和正在成熟的粒细胞不受控制地增殖，同时存在费城染色体。淋巴结病是慢性髓性白血病罕见的初始表现，通常归因于该疾病本身。然而，使用可影响T细胞介导免疫的酪氨酸激酶抑制剂（TKIs）后，慢性髓性白血病患者出现新的或持续的淋巴结病需要进行调查，以排除机会性感染，包括结核病（TB），或排除疾病进展至慢性髓性白血病的急变期。
一名35岁男性被诊断为慢性期慢性髓性白血病，最初表现为颈部淋巴结病。该淋巴结病最初归因于慢性髓性白血病。进一步评估，包括淋巴结活检，发现同时存在结核感染。采用适当的抗结核治疗后，淋巴结病得到缓解。
本病例强调了在出现淋巴结病的慢性髓性白血病患者中，尤其是接受酪氨酸激酶抑制剂治疗的患者中，考虑机会性感染（如结核病）的重要性。及时调查和适当管理对于避免并发症和确保患者获得最佳治疗效果至关重要。
