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Chronic myelogenous leukemia accompanied by megaloblastic anemia showing atypical clinical features.
Rinsho Ketsueki. 2011 Nov; 52(11):1772-6.RK

Abstract

Leukocytosis, splenomegaly, and an increased vitamin B(12) level are characteristic findings of chronic myelogenous leukemia in the chronic phase (CML-CP). Here, we report a patient with CML-CP accompanied by megaloblastic anemia. A 61-year-old man consulted our hospital because of anemia and thrombocytopenia. On physical examination, there were no remarkable findings; there was no hepatosplenomegaly. Laboratory findings were: hemoglobin 6.0 g/dl; MCV 113.6 fl; platelet count 100×10(9)/l; white cell count 8.66×10(9)/l; and LDH 1,236 IU/l. Peripheral blood smear demonstrated hypersegmented neutrophils and megalocytes with emergence of myeloblasts, giant metamyelocytes, and nucleated red cells. Vitamin B(12) and folic acid levels were low. Bone marrow examination showed megaloblastic change in the erythroblasts and myeloid hyperplasia. Following vitamin B(12) and folic acid administration, anemia and thrombocytopenia rapidly improved; thereafter, marked leukocytosis became evident. Based on the presence of t(9;22)(q34;q11) on cytogenetic study and a positive result for Major bcr/abl fusion gene, a diagnosis of CML-CP was established. This case illustrates that ineffective erythropoiesis results in anemia and thrombocytopenia in CML with vitamin B12 and/or folic acid deficiency.

Authors+Show Affiliations

Gunma University Graduate School of Medicine, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

22185800

Citation

Koiso, Hiromi, et al. "Chronic Myelogenous Leukemia Accompanied By Megaloblastic Anemia Showing Atypical Clinical Features." [Rinsho Ketsueki] the Japanese Journal of Clinical Hematology, vol. 52, no. 11, 2011, pp. 1772-6.
Koiso H, Tsukamoto N, Shimano S, et al. Chronic myelogenous leukemia accompanied by megaloblastic anemia showing atypical clinical features. Rinsho Ketsueki. 2011;52(11):1772-6.
Koiso, H., Tsukamoto, N., Shimano, S., Karasawa, M., Murakami, H., & Nojima, Y. (2011). Chronic myelogenous leukemia accompanied by megaloblastic anemia showing atypical clinical features. [Rinsho Ketsueki] the Japanese Journal of Clinical Hematology, 52(11), 1772-6.
Koiso H, et al. Chronic Myelogenous Leukemia Accompanied By Megaloblastic Anemia Showing Atypical Clinical Features. Rinsho Ketsueki. 2011;52(11):1772-6. PubMed PMID: 22185800.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic myelogenous leukemia accompanied by megaloblastic anemia showing atypical clinical features. AU - Koiso,Hiromi, AU - Tsukamoto,Norifumi, AU - Shimano,Shun-ichi, AU - Karasawa,Masamitsu, AU - Murakami,Hirokazu, AU - Nojima,Yoshihisa, PY - 2011/12/22/entrez PY - 2011/12/22/pubmed PY - 2012/2/10/medline SP - 1772 EP - 6 JF - [Rinsho ketsueki] The Japanese journal of clinical hematology JO - Rinsho Ketsueki VL - 52 IS - 11 N2 - Leukocytosis, splenomegaly, and an increased vitamin B(12) level are characteristic findings of chronic myelogenous leukemia in the chronic phase (CML-CP). Here, we report a patient with CML-CP accompanied by megaloblastic anemia. A 61-year-old man consulted our hospital because of anemia and thrombocytopenia. On physical examination, there were no remarkable findings; there was no hepatosplenomegaly. Laboratory findings were: hemoglobin 6.0 g/dl; MCV 113.6 fl; platelet count 100×10(9)/l; white cell count 8.66×10(9)/l; and LDH 1,236 IU/l. Peripheral blood smear demonstrated hypersegmented neutrophils and megalocytes with emergence of myeloblasts, giant metamyelocytes, and nucleated red cells. Vitamin B(12) and folic acid levels were low. Bone marrow examination showed megaloblastic change in the erythroblasts and myeloid hyperplasia. Following vitamin B(12) and folic acid administration, anemia and thrombocytopenia rapidly improved; thereafter, marked leukocytosis became evident. Based on the presence of t(9;22)(q34;q11) on cytogenetic study and a positive result for Major bcr/abl fusion gene, a diagnosis of CML-CP was established. This case illustrates that ineffective erythropoiesis results in anemia and thrombocytopenia in CML with vitamin B12 and/or folic acid deficiency. SN - 0485-1439 UR - https://www.unboundmedicine.com/medline/citation/22185800/Chronic_myelogenous_leukemia_accompanied_by_megaloblastic_anemia_showing_atypical_clinical_features_ L2 - http://joi.jlc.jst.go.jp/JST.JSTAGE/rinketsu/52.1772?lang=en&from=PubMed DB - PRIME DP - Unbound Medicine ER -