Ischemic stroke as a presenting feature of promyelocytic blast phase in chronic myeloid leukemia - an uncommon presentation: a case report and literature review in the post imatinib era.

IF 3 3区医学 Q2 HEMATOLOGY Annals of Hematology Pub Date : 2024-10-16 DOI:10.1007/s00277-024-06044-9

Swapnil Tripathi, Vinu Balraam K V, Amiya Ranjan Nayak, Richa Chauhan, Pradeep Kumar, Jasmita Dass, Priyanka Naranje, Mukul Aggarwal

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Abstract

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm (MPN characterized by reciprocal translocation in the ABL1 and BCR region of chromosomes 9 and 22 respectively. Progression to the blast phase in chronic myeloid leukemia results in a poorer prognosis. It can be of either myeloid, lymphoid or a mixed lineage. Progression to the promyelocytic blast phase is very rare, and there are no evidence-based guidelines for its management. Thrombosis in CML is not well defined. Thrombosis can be seen in patients with acute promyelocytic leukemia (APL) with venous thrombosis (VTE) being more common than arterial thrombosis. Ischemic stroke as the presenting feature of blast phase progression in CML is extremely rare. We report a case of CML who presented to us with acute ischemic stroke and subsequently was diagnosed as CML transformed to the promyelocytic blast phase. She was successfully treated with dasatinib along with all-trans retinoic acid (ATRA) and arsenic trioxide (ATO).

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缺血性中风作为慢性粒细胞白血病早幼粒细胞暴发性期的一种表现特征--一种不常见的表现：后伊马替尼时代的病例报告和文献综述。

慢性髓性白血病（CML）是一种骨髓增生性肿瘤（MPN），其特征是第 9 号和第 22 号染色体的 ABL1 和 BCR 区域分别发生互变。慢性髓性白血病进展到爆发期，预后较差。它可以是髓系，也可以是淋巴系或混合系。进展到早幼粒细胞鼓泡期的情况非常罕见，目前还没有循证指南来处理这种情况。CML 中血栓形成的定义尚不明确。急性早幼粒细胞白血病（APL）患者可出现血栓形成，其中静脉血栓形成（VTE）比动脉血栓形成更为常见。缺血性中风作为 CML 爆发期进展的主要特征极为罕见。我们报告了一例因急性缺血性中风就诊的 CML 患者，她随后被诊断为 CML 已转化为早幼粒细胞爆发期。她成功接受了达沙替尼以及全反式维甲酸（ATRA）和三氧化二砷（ATO）的治疗。

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来源期刊

Annals of Hematology 医学-血液学

CiteScore

5.60

自引率

2.90%

发文量

304

审稿时长

2 months

期刊介绍： Annals of Hematology covers the whole spectrum of clinical and experimental hematology, hemostaseology, blood transfusion, and related aspects of medical oncology, including diagnosis and treatment of leukemias, lymphatic neoplasias and solid tumors, and transplantation of hematopoietic stem cells. Coverage includes general aspects of oncology, molecular biology and immunology as pertinent to problems of human blood disease. The journal is associated with the German Society for Hematology and Medical Oncology, and the Austrian Society for Hematology and Oncology.