CHRONIC MYELOMONOCYTIC LEUKEMIA CASE PRESENTATION
Abstract:
Chronic myelomonocytic leukemia (CMML) is a heterogeneous group of disorders with
features both of myelodysplasia and of myeloproliferation: myelodysplastic / myeloproliferative
diseases. In the 2008 revision of the World Health Organization (WHO) classification of myeloid
neoplasms and acute leukemia, the subgroup designated as „myelodysplastic / myeloproliferative
diseases” has been renamed „myelodysplastic / myeloproliferative neoplasms (MDS/MPN). This
subgroup comprises CMML, atypical chronic myelogenous leukemia (aCML) juvenile myelomonocytic
leukemia (JMML) and a provisional entity within the MDS/MPN unclassifiable group, refractory anemia
with ring sideroblasts and thrombocytosis (RARS-t). I present the case of a 76 years-old male admitted
in Hematology Department of Sibiu County Hospital for the analysis of the leukocytosis with
splenomegaly. The clinical exam and the paraclinic investigations of this patient were performed: the
hemogram with cytology, morphological and hystopathological exam of bone marrow, cytogenetic study
and molecular biology tests. The patient presented in Hematology Department in may 2007 with
splenomegaly. The hemogram showed leukocytosis (90000/μl) with deviation to the left of the leucocyte
formula to 2% myeloblasts and monocytosis (1800/μl). The bone marrow aspirate and biopsy showed
hipercellularity with trilineal myelodysplasia. The cytogenetic study revealed the absence of
Philadelphia chromosome. The molecular biology tests were negative for BCR-ABL1. The patient
presents criteria of CMML I (WHO criteria). The patient followed treatment with Hydreea. The
presence of this rare disease, chronic myelomonocytic leukemia, underlines the importance of
performing complete paraclinic investigations for elucidation of this entity.
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