Pediatric Chronic Myeloid Leukemia Presenting With Extreme Thrombocytosis Simulating Essential Thrombocythemia

Abstract

A 10-year-old boy presented with spontaneous bruising and was found to have extreme thrombocytosis without neutrophilia/shift to immaturity, basophilia or eosinophilia. While the peripheral blood and bone marrow findings initially suggested essential thrombocythemia, BCR-ABL1 translocation was detected and chronic myeloid leukemia, chronic phase, was diagnosed. Apheresis for platelet depletion was performed as a bridge given the delayed effects of medical therapy.

Pediatric Chronic Myeloid Leukemia Presenting With Extreme Thrombocytosis and Acute Upper Gastrointestinal Hemorrhage: A Case Report

“…6 Including the case mentioned above, only 6 children with CML presenting with isolated extreme thrombocytosis have been reported (Table 1). [7][8][9][10][11]…”

“…Including the case mentioned above, only 6 children with CML presenting with isolated extreme thrombocytosis have been reported (Table 1). 7–11 These cases emphasize the need to detect BCR-ABL transcripts and the Philadelphia chromosome when patients present with thrombocytosis, without an elevated WBC count and splenomegaly, or with atypical BM results.…”