A case of chronic myeloid leukaemia in blast transformation with leukemic ascites
- Author:
Mohd Ridzuan Mohd Said
;
Ernie Yap
;
Wan Fariza Wan Jamaluddin
;
Fadilah S Abdul Wahid
;
Salwati Shuib
- Publication Type:Case Reports
- Keywords:
CML;
blast phase;
liver infiltration;
leukaemic ascites
- MeSH:
Leukemia, Myeloid, Acute
- From:
The Medical Journal of Malaysia
2016;71(2):85-87
- CountryMalaysia
- Language:English
-
Abstract:
Chronic Myeloid Leukaemia (CML) is a disease
characterised by a distinctive marker that is the Philadelphia
Chromosome and an ability to transform into blast phase,
which confers a poor prognosis. The median survival was
reported to be between three to six months in correlation to
blast phase. Extramedullary involvement with CML to sites
such as pleural, meningeal and bones have been reported.
We report a case of 41-year-old man who was diagnosed
with CML in blast phase and presented with ascites.
Ultrasound of abdomen showed coarse echotexture of liver
suggestive leukaemic infiltration to the liver. The liver profile
was severely deranged and associated with coagulopathy.
Flow cytometry analysis of the peritoneal fluid revealed
presence of myeloblasts consistent with CML in blast crisis
with leukaemic ascites. Bone marrow biopsy also confirmed
disease transformation. He received standard induction
chemotherapy for acute myeloid leukaemia with dose
modifications based on liver enzymes performance. Our
case highlights an unusual presentation of CML in blast
crisis with leukaemic ascites and the challenges in
managing cytotoxic treatments due to the liver infiltration.
- Full text:P020160628430963591635.pdf
