Document Detail

Emergence of chronic myelogenous leukemia during treatment for essential thrombocythemia.
MedLine Citation:
PMID:  20146031     Owner:  NLM     Status:  MEDLINE    
A 72-year-old male patient was initially diagnosed with essential thrombocythemia (ET), a Philadelphia chromosome-negative (Ph1(-)) chronic myeloproliferative disorder (CMPD), and was treated with hydroxyurea (HU). After 9 years of diagnosis of ET, his peripheral leukocytes gradually increased, while his platelet count showed a decrease. Bone marrow analysis disclosed Ph-positive chronic myelogenous leukemia (CML) in the chronic phase. Administration of imatinib mesylate (IM), a Bcr-Abl tyrosine kinase inhibitor (TKI), induced complete hematologic response in a month, but was discontinued after 4 months because of Grade 3 pleural effusion (PE). The treatment was switched to nilotinib which successfully induced a complete cytogenetic response (CCyR) after 5 months of TKI therapy and resolved the PE. Despite CCyR, however, ET recurred. Since then, the patient has been treated for 8 months with a combination of nilotinib and HU which has successfully controlled both CML and ET. This report includes a review of the characteristics of 15 reported cases with co-occurrence of CML and Bcr-Abl-negative CMPDs, including ours. Although rare, care needs to be taken since, despite the often similar clinical features of the two diseases, they require completely different treatments.
Shinsuke Mizutani; Junya Kuroda; Daisuke Shimizu; Shigeo Horiike; Masafumi Taniwaki
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2010-02-11
Journal Detail:
Title:  International journal of hematology     Volume:  91     ISSN:  1865-3774     ISO Abbreviation:  Int. J. Hematol.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-05     Completed Date:  2010-06-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111627     Medline TA:  Int J Hematol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  516-21     Citation Subset:  IM    
Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan.
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MeSH Terms
Antineoplastic Agents / therapeutic use
Hydroxyurea / therapeutic use*
Leukemia, Myelogenous, Chronic, BCR-ABL Positive / complications*,  diagnosis*
Thrombocythemia, Essential / complications*,  drug therapy*
Reg. No./Substance:
0/Antineoplastic Agents; 127-07-1/Hydroxyurea

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