Araştırma Makalesi
BibTex RIS Kaynak Göster

Patients with Chronic Myeloid Leukemia Diagnosed with Predominant Thrombocytosis without Marked Leukocytosis: Case Series

Yıl 2025, Cilt: 47 Sayı: 5, 706 - 711, 04.09.2025
https://doi.org/10.20515/otd.1698894

Öz

Chronic myeloid leukemia (CML) is a clonal hematopoietic pluripotent stem cell disease characterized by excessive and uncontrolled proliferation of myeloid lineage cells. Platelet count is increased in more than half of patients and the appearance of platelets is variable. When patients present with predominant thrombocytosis without marked leukocytosis, they should be tested for the Philadelphia chromosome or (breakpoint cluster region- Abelson) BCR-ABL to distinguish cases of CML. In this study, the data of 215 patients diagnosed with CML between 2010 and 2023 were retrospectively evaluated. The study enrolled patients aged ≥18 years with leukocyte count <40 x109/L and platelet count >500 x109/L at the time of diagnosis. While investigating the etiology of predominant thrombocytosis and no significant leukocytosis, 13 patients diagnosed with CML were identified. The proportion of these patients among all patients with CML was 6%. This study showed that CML should be considered in the differential diagnosis of patients with predominant thrombocytosis without marked leukocytosis. In these patients, the Ph chromosome should definitely be checked before ET is diagnosed. Making a correct diagnosis in this patient group is important in order to start tyrosine kinase inhibitor treatment before it progresses to accelerated or blastic phases.

Etik Beyan

Approval for the study was obtained from the Eskişehir Osmangazi University Non-Interventional Ethics Committee with the number 21.02.2023-37.

Destekleyen Kurum

yok

Kaynakça

  • 1. Geary CG. The story of chronic myeloid leukaemia: Historical review. British journal of haematology. 2000;110(1):2-11.
  • 2. Tefferi A, Vardiman JW. Classification and diagnosis of myeloproliferative neoplasms: the 2008 World Health Organization criteria and point-of-care diagnostic algorithms. leukemia. 2008;22(1):14-22.
  • 3. Goldman JM, Melo JV. Chronic myeloid leukemia—advances in biology and new approaches to treatment. New England Journal of Medicine. 2003;349(15):1451-64.
  • 4. Granatowicz A, Piatek CI, Moschiano E, El-Hemaidi I, Armitage JD, Akhtari M. An overview and update of chronic myeloid leukemia for primary care physicians. Korean journal of family medicine. 2015;36(5):197.
  • 5. Savage DG, Szydlo RM, Goldman JM. Clinical features at diagnosis in 430 patients with chronic myeloid leukaemia seen at a referral centre over a 16-year period. British journal of haematology. 1997;96(1):111-6.
  • 6. Galinsky I, Buchanan S. Guide to interpreting disease responses in chronic myeloid leukemia. Journal of the advanced practitioner in oncology. 2012;3(4):225.
  • 7. Byun YJ, Park BB, Lee ES, Choi KS, Lee DS. A case of chronic myeloid leukemia with features of essential thrombocythemia in peripheral blood and bone marrow. Blood research. 2014;49(2):127.
  • 8. Findakly D, Arslan W. Clinical features and outcomes of patients with chronic myeloid leukemia presenting with isolated thrombocytosis: a systematic review and a case from our institution. Cureus. 2020;12(6).
  • 9. Gao L, Ren M qiang, Tian Z guo, Peng Z yuan, Shi G, Yuan Z. Management of chronic myeloid leukemia presenting with isolated thrombocytosis and complex Philadelphia chromosome: a case report. Medicine. 2021;100(35).
  • 10. Coster L, Mansat-De MAS V, Largeaud L, Voisin S, Corre J, Gauthier M. Chronic Myeloid Leukaemia with isolated massive thrombocytosis and BCR-ABL1 detection failure using RT-MLPA (positive RT-qPCR). EJHaem. 2021;2(3):655.
  • 11. Cotta CV, Bueso-Ramos CE. New insights into the pathobiology and treatment of chronic myelogenous leukemia. Annals of Diagnostic Pathology. 2007;11(1):68-78.
  • 12. Lundberg LG, Lerner R, Sundelin P, Rogers R, Folkman J, Palmblad J. Bone marrow in polycythemia vera, chronic myelocytic leukemia, and myelofibrosis has an increased vascularity. The American journal of pathology. 2000;157(1):15-9.
  • 13. Tober J, Koniski A, McGrath KE, Vemishetti R, Emerson R, de Mesy-Bentley KK, et al. The megakaryocyte lineage originates from hemangioblast precursors and is an integral component both of primitive and of definitive hematopoiesis. Blood. 2007;109(4):1433-41.
  • 14. Wei G, Rafiyath S, Liu D. First-line treatment for chronic myeloid leukemia: dasatinib, nilotinib, or imatinib. Journal of hematology & oncology. 2010;3:1-10.
  • 15. Findakly D, Arslan W. Chronic myeloid leukemia: atypical presentation and diagnostic pitfall in the workup of isolated thrombocytosis. Cureus. 2020;12(6).
  • 16. Jabbour E, Kantarjian H. Chronic myeloid leukemia: 2018 update on diagnosis, therapy and monitoring. American journal of hematology. 2018;93(3):442-59.

Belirgin Lökositoz Olmaksizin Baskin Trombositozla Tani Alan Kronik Miyeloid Lösemili Hastalar: Vaka Serisi

Yıl 2025, Cilt: 47 Sayı: 5, 706 - 711, 04.09.2025
https://doi.org/10.20515/otd.1698894

Öz

Kronik miyeloid lösemi (KML), miyeloid seri hücrelerinin aşırı ve kontrolsüz çoğalmasıyla karakterize klonal hematopoietik pluripotent bir kök hücre hastalığıdır. Hastaların yarısından fazlasında trombosit sayısı artmıştır ve trombositlerin görünümü değişkendir. Hastalarda belirgin lökositoz olmaksızın baskın trombositoz mevcutsa, KML vakalarını ayırt etmek için Philadelphia kromozomu veya (breakpoint cluster region -Abelson) BCR-ABL testi yapılmalıdır. Bu çalışmada 2010-2023 yılları arasında KML tanısı almış 215 hastanın verileri retrospektif olarak değerlendirildi. Çalışmaya tanı anında lökosit sayısı <40 x109/L ve trombosit sayısı >500 x109/L olan ≥18 yaş hastalar dahil edildi. Belirgin lökositoz olmadan baskın trombositozla tetkik edilirken KML tanısı alan 13 hasta belirlendi. Bu hastaların tüm KML hastaları içindeki oranı %6 bulundu. Bu çalışma, belirgin lökositoz olmaksızın baskın trombositozu olan hastaların ayırıcı tanısında KML'nin düşünülmesi gerektiğini göstermektedir. Bu hastalarda ET tanısı konulmadan önce mutlaka Ph kromozomuna bakılmalıdır. Bu hasta grubunda doğru tanı koymak, hastalığın akselere veya blastik faza ilerlemeden tirozin kinaz inhibitörü tedavisine başlanması açısından önemlidir.

Kaynakça

  • 1. Geary CG. The story of chronic myeloid leukaemia: Historical review. British journal of haematology. 2000;110(1):2-11.
  • 2. Tefferi A, Vardiman JW. Classification and diagnosis of myeloproliferative neoplasms: the 2008 World Health Organization criteria and point-of-care diagnostic algorithms. leukemia. 2008;22(1):14-22.
  • 3. Goldman JM, Melo JV. Chronic myeloid leukemia—advances in biology and new approaches to treatment. New England Journal of Medicine. 2003;349(15):1451-64.
  • 4. Granatowicz A, Piatek CI, Moschiano E, El-Hemaidi I, Armitage JD, Akhtari M. An overview and update of chronic myeloid leukemia for primary care physicians. Korean journal of family medicine. 2015;36(5):197.
  • 5. Savage DG, Szydlo RM, Goldman JM. Clinical features at diagnosis in 430 patients with chronic myeloid leukaemia seen at a referral centre over a 16-year period. British journal of haematology. 1997;96(1):111-6.
  • 6. Galinsky I, Buchanan S. Guide to interpreting disease responses in chronic myeloid leukemia. Journal of the advanced practitioner in oncology. 2012;3(4):225.
  • 7. Byun YJ, Park BB, Lee ES, Choi KS, Lee DS. A case of chronic myeloid leukemia with features of essential thrombocythemia in peripheral blood and bone marrow. Blood research. 2014;49(2):127.
  • 8. Findakly D, Arslan W. Clinical features and outcomes of patients with chronic myeloid leukemia presenting with isolated thrombocytosis: a systematic review and a case from our institution. Cureus. 2020;12(6).
  • 9. Gao L, Ren M qiang, Tian Z guo, Peng Z yuan, Shi G, Yuan Z. Management of chronic myeloid leukemia presenting with isolated thrombocytosis and complex Philadelphia chromosome: a case report. Medicine. 2021;100(35).
  • 10. Coster L, Mansat-De MAS V, Largeaud L, Voisin S, Corre J, Gauthier M. Chronic Myeloid Leukaemia with isolated massive thrombocytosis and BCR-ABL1 detection failure using RT-MLPA (positive RT-qPCR). EJHaem. 2021;2(3):655.
  • 11. Cotta CV, Bueso-Ramos CE. New insights into the pathobiology and treatment of chronic myelogenous leukemia. Annals of Diagnostic Pathology. 2007;11(1):68-78.
  • 12. Lundberg LG, Lerner R, Sundelin P, Rogers R, Folkman J, Palmblad J. Bone marrow in polycythemia vera, chronic myelocytic leukemia, and myelofibrosis has an increased vascularity. The American journal of pathology. 2000;157(1):15-9.
  • 13. Tober J, Koniski A, McGrath KE, Vemishetti R, Emerson R, de Mesy-Bentley KK, et al. The megakaryocyte lineage originates from hemangioblast precursors and is an integral component both of primitive and of definitive hematopoiesis. Blood. 2007;109(4):1433-41.
  • 14. Wei G, Rafiyath S, Liu D. First-line treatment for chronic myeloid leukemia: dasatinib, nilotinib, or imatinib. Journal of hematology & oncology. 2010;3:1-10.
  • 15. Findakly D, Arslan W. Chronic myeloid leukemia: atypical presentation and diagnostic pitfall in the workup of isolated thrombocytosis. Cureus. 2020;12(6).
  • 16. Jabbour E, Kantarjian H. Chronic myeloid leukemia: 2018 update on diagnosis, therapy and monitoring. American journal of hematology. 2018;93(3):442-59.
Toplam 16 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Onkoloji
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Fatih Yaman 0000-0002-0494-571X

Filiz Yavaşoğlu 0000-0002-4017-4668

Neslihan Andıc 0000-0003-0510-4733

Eren Gunduz 0000-0001-7455-2949

Hava Üsküdar Teke 0000-0002-4434-4580

Yayımlanma Tarihi 4 Eylül 2025
Gönderilme Tarihi 14 Mayıs 2025
Kabul Tarihi 17 Haziran 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 47 Sayı: 5

Kaynak Göster

Vancouver Yaman F, Yavaşoğlu F, Andıc N, Gunduz E, Üsküdar Teke H. Patients with Chronic Myeloid Leukemia Diagnosed with Predominant Thrombocytosis without Marked Leukocytosis: Case Series. Osmangazi Tıp Dergisi. 2025;47(5):706-11.


13299        13308       13306       13305    13307  1330126978