Simultaneous Manifestation of Chronic Myelomonocytic Leukemia and Multiple Myeloma during Treatment by Prednisolone and Eltrombopag for Immune-Mediated Thrombocytopenic Purpura

Hagihara, Masao; Inoue, Morihiro; Kodama, Kenichiro; Uchida, Tatsuo; Jiang, Hua

doi:10.1155/2016/4342820

Cited by 4 publications

(3 citation statements)

References 35 publications

(32 reference statements)

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“…The latter group includes patients who (i) received chemotherapy and/or radiation therapy in the past (therapy-related CMML) or (ii) have a history of a preceding MDS, MPN or another indolent myeloid or mast cell neoplasm prior to their diagnosis of CMML. 51,57,58,61-64 Recent data suggest that patients with therapy-related secondary CMML may have shorter overall survival compared to that of patients with primary ( de novo ) CMML. 65 Although progression-free survival may not be different in these patients compared to those with de novo CMML, some of these patients progress rapidly to secondary AML.…”

Section: Introductionmentioning

confidence: 99%

Proposed diagnostic criteria for classical chronic myelomonocytic leukemia (CMML), CMML variants and pre-CMML conditions

et al. 2019

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Chronic myelomonocytic leukemia (CMML) is a myeloid neoplasm characterized by dysplasia, abnormal production and accumulation of monocytic cells and an elevated risk of transforming into acute leukemia. Over the past two decades, our knowledge about the pathogenesis and molecular mechanisms in CMML has increased substantially. In parallel, better diagnostic criteria and therapeutic strategies have been developed. However, many questions remain regarding prognostication and optimal therapy. In addition, there is a need to define potential pre-phases of CMML and special CMML variants, and to separate these entities from each other and from conditions mimicking CMML. To address these unmet needs, an international consensus group met in a Working Conference in August 2018 and discussed open questions and issues around CMML, its variants, and pre-CMML conditions. The outcomes of this meeting are summarized herein and include diag nostic criteria and a proposed classification of pre-CMML conditions as well as refined minimal diagnostic criteria for classical CMML and special CMML variants, including oligomonocytic CMML and CMML associated with systemic mastocytosis. Moreover, we propose diagnostic standards and tools to distinguish between ‘normal’, pre-CMML and CMML entities. These criteria and standards should facilitate diagnostic and prognostic evaluations in daily practice and clinical studies in applied hematology.

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Section: Introductionmentioning

confidence: 99%

Proposed diagnostic criteria for classical chronic myelomonocytic leukemia (CMML), CMML variants and pre-CMML conditions

et al. 2019

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“…However, there have been case reports where patient being treated with an alkylating agent for MM later developed CMML. In a report by Ueki et al, in 37 patients with MM who were being treated with melphalan, three of those patients had later developed CMML as well [ 5 ]. A similar finding was observed by Natazuka et al, where a patient with MM treated with melphalan presented after 6.5 years with features of CMML [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

To Treat or Not to Treat: A Case of Simultaneous Discovery of Chronic Myelomonocytic Leukemia and Multiple Myeloma

Siddiqui¹,

Farhan²,

Nguyen³

2021

Cureus

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The coexistence of multiple myeloma and chronic myelomonocytic leukemia in the same patient is a rare entity. Here we describe a case of an 80-year-old man who presented to our hospital with symptoms of dyspnea and found to have anemia and leukocytosis with peripheral monocytosis. Bone marrow biopsy, flow cytometry, and fluorescence in situ hybridization studies were consistent with a laboratory diagnosis of multiple myeloma and chronic myelomonocytic leukemia. Due to advanced age and multiple comorbidities, the patient was treated conservatively. At 26 months follow-up, the patient continues to do well.

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“…[5][6][7][8][9][10] In most cases, the lymphoid neoplasm is diagnosed first, and the CMML is considered to be a secondary therapyinduced form of leukemia. [11][12][13][14][15] We report herein a unique case of de-novo CMML, with an underlying clonal T-cell population and describe its clinical presentation and laboratory findings.…”

Section: Introductionmentioning

confidence: 99%

Occurrence of a Clonal T-Cell Population in a Case of Chronic Myelomonocytic Leukemia

Patil

Wanve

Kar

et al. 2021

Clin Med�Insights�Blood�Disord

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Chronic myelo-monocytic leukemia (CMML) is an aggressive myeloid neoplasm with some features of a myelodysplastic syndrome (MDS) and others of a myeloproliferative neoplasm (MPN). Rarely, patients with CMML have a co-existing lympho-proliferative disorder (LPD). In most cases, the lymphoid neoplasm is diagnosed first, and the CMML is considered to be a secondary therapy-induced form of leukemia. We report herein a unique case of de-novo CMML, with an underlying clonal T-cell population and describe its clinical presentation and laboratory findings. A 70-year old male presented with a 3-month history of cough, dsypnea, abdominal distension, and low-grade fever. Physical and radiological examination revealed hepatosplenomegaly but no lymphadenopathy. Peripheral blood had absolute monocytosis with marrow showing CMML with 10% blasts along with dysplasia in myeloid and erythroid lineages. Flow cytometry indicated possibility of chronic myelo-monocytic leukemia with 13% monocytic cells along with an additional clonal population of gamma/delta T cells (15%) with aberrant immunophenotype. Polymerase chain reaction (PCR) analysis was positive for clonal T-cell rearrangement. A diagnosis of CMML with an underlying clonal T-CLPD was made. The synchronous occurrence of CMML and T-cell neoplasm may be attributed to a genetic mutation common to both. Currently, there are no treatment guidelines for group of patients; hence individualized therapeutic strategies should be implemented to enable symptomatic improvement and provide optimum care.

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Simultaneous Manifestation of Chronic Myelomonocytic Leukemia and Multiple Myeloma during Treatment by Prednisolone and Eltrombopag for Immune-Mediated Thrombocytopenic Purpura

Cited by 4 publications

References 35 publications

Proposed diagnostic criteria for classical chronic myelomonocytic leukemia (CMML), CMML variants and pre-CMML conditions

Proposed diagnostic criteria for classical chronic myelomonocytic leukemia (CMML), CMML variants and pre-CMML conditions

To Treat or Not to Treat: A Case of Simultaneous Discovery of Chronic Myelomonocytic Leukemia and Multiple Myeloma

Occurrence of a Clonal T-Cell Population in a Case of Chronic Myelomonocytic Leukemia

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