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Extensive Bone Lesions and Skin Lesions Revealing an Acute Transformation of an Extramedullary Chronic Myeloid Leukemia

Received: 13 March 2018     Accepted: 29 March 2018     Published: 5 May 2018
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Abstract

Extramedullary blast transformation as the initial presentation of Chronic Myeloid Leukemia with bone marrow remaining in the chronic phase is an unusual event. We report the case of a 30-year-old with chronic CML at the medullary level and an acute transformation revealed by extensive bone lyses and skin lesions. A 30-year-old man had cutaneous nodules, functional impotence and paresis. Radiological investigations revealed osteolytic lesions of the right humeral head, right clavicle, ribs, C5 and C7 vertebrae with medullary compression. Anatomo-pathological study and immunohistochemistry of nodules and osteolytic lesions resulted in granulocytic sarcoma with CD10 +, CD34 +, CD13 +, CD33 +, CD117 and MPO positive. The myelogram was in favor of chronic phase CML. He was put on imatinib, the chemotherapy could not be started because his condition was impaired and he dies by metabolic disorder. The acute transformation of chronic phase CML into extra marrow remains unusual. The care is a real challenge hence the need for consensual recommendations.

Published in Cancer Research Journal (Volume 6, Issue 2)
DOI 10.11648/j.crj.20180602.15
Page(s) 70-73
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Acute Transformation, Chronic Myeloid Leukemia, Bones lesions, Skin Lesions

References
[1] Jin GN, Zou P, Chen WX, Ding ZY, Zhou H. Fluorescent in situ hybridization diagnosis of extramedullary nodal blast crisis. Diagn Cytopathol. 2013; 41 (4):253–256.
[2] Shune L, Cayci Z, Rogosheske J, Brunstein C, Ustun C. Extramedullary blastic crisis in abdominal lymph nodes in a patient with chronic myelogenous leukemia on imatinib. Leuk Res. 2012; 36 (6):e131–e132.
[3] Gao X, Li J, Wang L, Lin J, Jin H, Xu Y, Wang N, et al. Bilineal Extramedullary Blast Crisis as an Initial Presentation of Chronic Myeloid Leukemia: A Case Report and Literature Review. Am J Case Rep. 2016: 27; 17:793-798.
[4] Levy RA, Mardones MA, Burch MM, Krause JR. Myeloid sarcoma as the presenting symptom of chronic myelogenous leukemia blast crisis. Proc (Bayl Univ Med Cent) 2014; 27 (3):246–49.
[5] Kantarjan HM, Keating MJ, Talpaz M. Chronic myelogenous leukemia in blast crisis: analysis of 242 patients. Am J Med. 1987; 83:445–454.
[6] Canellos G. Clinical characteristics of the blast phase of chronic granulocytic leukemia. Hematol Oncol Clin North Am. 1990; 4:359–376.
[7] Specchia G, Palumbo G, Pastore D, Mininni D, Mestice A, Liso V. Extramedullary blast crises in chronic myeloid leukemia. Leuk Res. 1996; 20:905–908.
[8] O'Hare T, Walters DK, Stoffregen EP, Jia T, Manley PW, Mestan J, et al. In vitro activity of Bcr-Abl inhibitors AMN107 and BMS-354825 against clinically relevant imatinib-resistant Abl kinase domain mutants. Cancer Res. 2005; 65 (11):4500–4505.
[9] Porkka K, Koskenvesa P, Lundan T, Rimpilainen J, Mustjoki S, Smykla R, et al. Dasatinib crosses the blood-brain barrier and is an efficient the therapy for central nervous system Philadelphia chromosome-positive leukemia. Blood. 2008; 112 (4):1005–1012.
[10] Yu HH, Lu MY, Lin DT, Lin KH, Tang JL, Jou ST. Pathological fracture as a manifestation of extramedullary blastic crisis in chronic myelogenous leukemia: report of one case. Acta Paediatr Taiwan. 2006; 47 (3):150–154.
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  • APA Style

    Bienvenu Houssou, Mouna Lamchahab, Halima Hadri, Boubker Messoudi, Abdeljabbar Messoudi, et al. (2018). Extensive Bone Lesions and Skin Lesions Revealing an Acute Transformation of an Extramedullary Chronic Myeloid Leukemia. Cancer Research Journal, 6(2), 70-73. https://doi.org/10.11648/j.crj.20180602.15

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    ACS Style

    Bienvenu Houssou; Mouna Lamchahab; Halima Hadri; Boubker Messoudi; Abdeljabbar Messoudi, et al. Extensive Bone Lesions and Skin Lesions Revealing an Acute Transformation of an Extramedullary Chronic Myeloid Leukemia. Cancer Res. J. 2018, 6(2), 70-73. doi: 10.11648/j.crj.20180602.15

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    AMA Style

    Bienvenu Houssou, Mouna Lamchahab, Halima Hadri, Boubker Messoudi, Abdeljabbar Messoudi, et al. Extensive Bone Lesions and Skin Lesions Revealing an Acute Transformation of an Extramedullary Chronic Myeloid Leukemia. Cancer Res J. 2018;6(2):70-73. doi: 10.11648/j.crj.20180602.15

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  • @article{10.11648/j.crj.20180602.15,
      author = {Bienvenu Houssou and Mouna Lamchahab and Halima Hadri and Boubker Messoudi and Abdeljabbar Messoudi and Asma Quessar},
      title = {Extensive Bone Lesions and Skin Lesions Revealing an Acute Transformation of an Extramedullary Chronic Myeloid Leukemia},
      journal = {Cancer Research Journal},
      volume = {6},
      number = {2},
      pages = {70-73},
      doi = {10.11648/j.crj.20180602.15},
      url = {https://doi.org/10.11648/j.crj.20180602.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.crj.20180602.15},
      abstract = {Extramedullary blast transformation as the initial presentation of Chronic Myeloid Leukemia with bone marrow remaining in the chronic phase is an unusual event. We report the case of a 30-year-old with chronic CML at the medullary level and an acute transformation revealed by extensive bone lyses and skin lesions. A 30-year-old man had cutaneous nodules, functional impotence and paresis. Radiological investigations revealed osteolytic lesions of the right humeral head, right clavicle, ribs, C5 and C7 vertebrae with medullary compression. Anatomo-pathological study and immunohistochemistry of nodules and osteolytic lesions resulted in granulocytic sarcoma with CD10 +, CD34 +, CD13 +, CD33 +, CD117 and MPO positive. The myelogram was in favor of chronic phase CML. He was put on imatinib, the chemotherapy could not be started because his condition was impaired and he dies by metabolic disorder. The acute transformation of chronic phase CML into extra marrow remains unusual. The care is a real challenge hence the need for consensual recommendations.},
     year = {2018}
    }
    

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  • TY  - JOUR
    T1  - Extensive Bone Lesions and Skin Lesions Revealing an Acute Transformation of an Extramedullary Chronic Myeloid Leukemia
    AU  - Bienvenu Houssou
    AU  - Mouna Lamchahab
    AU  - Halima Hadri
    AU  - Boubker Messoudi
    AU  - Abdeljabbar Messoudi
    AU  - Asma Quessar
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    PY  - 2018
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    DO  - 10.11648/j.crj.20180602.15
    T2  - Cancer Research Journal
    JF  - Cancer Research Journal
    JO  - Cancer Research Journal
    SP  - 70
    EP  - 73
    PB  - Science Publishing Group
    SN  - 2330-8214
    UR  - https://doi.org/10.11648/j.crj.20180602.15
    AB  - Extramedullary blast transformation as the initial presentation of Chronic Myeloid Leukemia with bone marrow remaining in the chronic phase is an unusual event. We report the case of a 30-year-old with chronic CML at the medullary level and an acute transformation revealed by extensive bone lyses and skin lesions. A 30-year-old man had cutaneous nodules, functional impotence and paresis. Radiological investigations revealed osteolytic lesions of the right humeral head, right clavicle, ribs, C5 and C7 vertebrae with medullary compression. Anatomo-pathological study and immunohistochemistry of nodules and osteolytic lesions resulted in granulocytic sarcoma with CD10 +, CD34 +, CD13 +, CD33 +, CD117 and MPO positive. The myelogram was in favor of chronic phase CML. He was put on imatinib, the chemotherapy could not be started because his condition was impaired and he dies by metabolic disorder. The acute transformation of chronic phase CML into extra marrow remains unusual. The care is a real challenge hence the need for consensual recommendations.
    VL  - 6
    IS  - 2
    ER  - 

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Author Information
  • Department of Clinical Hematology and Pediatric Oncology, Hospital August 20th 1953, University Hassan II, Casablanca, Morocco

  • Department of Clinical Hematology and Pediatric Oncology, Hospital August 20th 1953, University Hassan II, Casablanca, Morocco

  • Department of Clinical Hematology and Pediatric Oncology, Hospital August 20th 1953, University Hassan II, Casablanca, Morocco

  • Department of Trauma and Orthopedic of the Hospital Ibn Rochd, University Hassan II, Casablanca, Morocco

  • Department of Trauma and Orthopedic of the Hospital Ibn Rochd, University Hassan II, Casablanca, Morocco

  • Department of Clinical Hematology and Pediatric Oncology, Hospital August 20th 1953, University Hassan II, Casablanca, Morocco

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