Chronic myeloid leukaemia with extreme thrombocytosis. (19th August 2015)

• Record Type: Journal Article
• Authors: Verma, Shailendra Prasad; Subbiah, Arunkumar; Jacob, Sajini Elizabeth; Basu, Debdatta
• Is Part Of: BMJ case reports. Volume 2015
• Publication Date: 2015-08-19
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2014-204564
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : We report two cases of chronic myeloid leukaemia (CML) with extreme thrombocytosis. The first patient was a 65-year-old man who presented with prolonged history of upper abdominal discomfort, anorexia and two episodes of recent gum bleeds without fever or other bleeding manifestations. He was a chronic smoker with no other comorbidities. Examination revealed moderate hepatosplenomegaly. On investigation, he was found to have extreme thrombocytosis (3 500 000/mm 3 ) and leucocytosis with moderate anaemia. In view of the leucocytosis, he was investigated for CML and found to be positive for BCR-ABL by reverse transcription PCR (RT-PCR). He received imatinib 400 mg/day and achieved complete haematological response at the end of 3 months. The second patient was a 7-year-old boy who presented with fever, cough and cold of 2-week duration. Examination revealed mild hepatomegaly with palpable spleen tip. Haemogram and peripheral smear revealed moderate leucocytosis with extreme thrombocytosis (2 800 000/mm 3 ). On evaluation, he was found to be BCR-ABL positive and responded well to imatinib treatment. In both these cases, massive thrombocytosis was an unusual presentation of a well-known entity, namely, CML. This degree of thrombocytosis is usually seen only in essential thrombocytosis.