Case report: Co-existing chronic myeloid leukemia and chronic myelomonocytic leukemia-A clinically important but challenging scenario

Jinming Song; Lynn Moscinski; Ling Zhang; Hailing Zhang

doi:10.1016/j.lrr.2023.100378

Case report: Co-existing chronic myeloid leukemia and chronic myelomonocytic leukemia-A clinically important but challenging scenario

Leuk Res Rep. 2023 Jun 21:20:100378. doi: 10.1016/j.lrr.2023.100378. eCollection 2023.

Authors

Jinming Song¹, Lynn Moscinski¹, Ling Zhang¹, Hailing Zhang¹

Affiliation

¹ Department of Hematopathology, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, United States of America.

Abstract

Chronic myeloid leukemia (CML) and chronic myelomonocytic leukemia (CMML) are two common myeloid neoplasms with overlapping morphologic features. We report a patient initially diagnosed with CML and treated with Tyrosine kinase inhibitor (TKI) but who then developed persistent monocytosis and worsening thrombocytopenia one year later. Repeat bone marrow biopsies only showed CML at the molecular level. However, markedly hypercellular bone marrow, megakaryocytic dysplasia, and SRSF2, TET2, and RUNX1 mutations by NextGen sequencing pointed to a diagnosis of CMML. For CML patients with persistent monocytosis and cytopenia, a mutational profile by NGS is helpful to exclude or identify the coexisting CMML.

Keywords: CML; CMML; Monocytosis; Myeloid.

Publication types

Case Reports