An Unusual Cause of Bleeding in a Patient with Chronic Myeloid Leukemia Chronic Phase

Abstract

Chronic myelogenous leukemia (CML) is a clonal myeloproliferative neoplasm (MPN) characterized by dysregulated and uncontrolled proliferation of mature and maturing granulocytes with normal differentiation. A genetic hallmark of CML is the presence of the fusion gene product BCR-ABL. Bleeding diathesis in CML patients is rare (<10%) and primarily caused by acquired platelet dysfunction. We report a rare case of an adult CML chronic phase patient who presented with spontaneous muscle hematoma due to acquired Glanzmann’s thrombasthenia (GT). On laboratory workup, a GT was confirmed along with the diagnosis of CML in chronic phase. The muscle hematoma was completely resolved following imatinib therapy. The present case demonstrates that bleeding is a complication of MPNs and highlights the importance of both acquired GT diagnosis to determine the cause of bleeding in CML and of prompt treatment with imatinib to reverse this condition.

Chronic myelogenous leukemia presenting with Morel Lavallée lesion: A case report of a rare presentation

“…Platelet dysfunction in CML can be attributed to the clonal expansion of dysfunctional megakaryocytes, which explains the expected improvement in platelet function after starting tyrosine kinase inhibitors. Expectant management, as well as treatment with tyrosine kinase inhibitors, can resolve the hematomas, as demonstrated in previously reported cases 6–8 …”

“…Expectant management, as well as treatment with tyrosine kinase inhibitors, can resolve the hematomas, as demonstrated in previously reported cases. [6][7][8] The Morel-Lavallée lesion (MLL) is a closed traumatic soft-tissue degloving injury. The French physician, Dr. Victor-Auguste-François Morel-Lavallée, was the first to describe the lesion in the year 1863.…”

Spontaneous scapular region hematoma extending upto anterior chest wall in a patient of chronic myeloid leukaemia: an unusual site presentation

“…Clonal expansion of megakaryocytes harbouring the 9:22 translocation have defective aggregation and can also develop acquired Glanzman thrombaesthenia phenotype. 8 Autoantibody against the platelets membrane proteins; gp 2b3a, defective PI3 kinase pathway, alpha2b-beta 3 downregulation is also considered an etiology. 9,10 Jain has reported a case of CML with acquired von willebrand disease presenting as subdural hematoma.…”

Uncontrolled per rectal bleeding in chronic myeloid leukaemia: a mere coincidence or a dangerous sign report of an unusual case

“…7 Platelet dysfunction is the primary cause of bleeding in patients with CML. 13 CML mimicking as bleeding per rectum with prolapsed haemorrhoids is a rare presenting complication and finds no mention so far in literature. The prolapsed haemorrhoids may be purely coincidental but persistent bleeding which needed an emergency surgery is something which cannot be ignored.…”