CHRONIC MYELOID LEUKAEMIA IN A 14-YEAR-OLD CHILD: AN UNUSUAL CASE REPORT

Authors

  • Syed Yar Muhammad Shah Medicine, Ayub Teaching Hospital Abbottabad
  • Rahman Bahadar Medicine, Ayub Teaching Hospital Abbottabad
  • Umer Zareen Medicine, Ayub Teaching Hospital Abbottabad
  • Abdullah Zeb Medicine, Ayub Teaching Hospital Abbottabad
  • Azizullah Medicine, Ayub Teaching Hospital Abbottabad
  • Ahmed Medicine, Ayub Teaching Hospital Abbottabad
  • Ameer Hamza Medicine, Ayub Teaching Hospital Abbottabad
  • Rafiullha Medicine, Ayub Teaching Hospital Abbottabad
  • Waqas Ahmad Medicine, Ayub Teaching Hospital Abbottabad
  • Syed Yasir Hussain Gilani Medicine, Ayub Teaching Hospital Abbottabad

DOI:

https://doi.org/10.55519/JAMC-03-S1-10066

Keywords:

Chronic myeloid leukemia, Myeloproliferative disorder, Bone marrow biopsy, FIS

Abstract

Chronic myeloid leukaemia is a myeloproliferative stem cell disorder characterized by dysregulated production and proliferation of myeloid cells. Hallmark of the disease is the reciprocal translocation between chromosome 9 and 22 giving rise to an abnormal chromosome known as Philadelphia chromosome. Approximately 15% of all leukaemias are chronic myeloid leukaemia with a slight male predominance. This is a case of a 14-year-old boy with no premorbid presented with 4 months history of fatigue and shortness of breath on exertion. On examination patient was vitally stable. On general physical examination there was pallor and sternal tenderness. On abdominal examination spleen was palpable with a size of about 8cm. Respiratory, cardiovascular and musculoskeletal examination was unremarkable. Complete blood picture showed leukocytosis, low haemoglobin and normal platelets. Erythrocyte sedimentation rate was 65 mm/hr. Liver function tests, Renal function tests, Serum electrolytes, Urine routine examination and c-reactive protein were normal. Chest x-ray and Electrocardiography was normal. Peripheral blood smear showed neutrophils 56% with 3% lymphocytes, 1% blasts and retic count of 0.5%. Bone marrow biopsy was suggestive of chronic myeloid leukaemia which was confirmed by FISH and Cytogenetic studies.

References

Kwaśnik P, Giannopoulos K. Treatment-Free Remission-A New Aim in the Treatment of Chronic Myeloid Leukaemia. J Pers Med 2021;11(8):697.

Hijiya N, Suttorp M. How I treat chronic myeloid leukaemia in children and adolescents. Blood 2019;133(22):2374–84.

Athale U, Hijiya N, Patterson BC, Bergsagel J, Andolina JR, Bittencourt H, et al. Management of chronic myeloid leukaemia in children and adolescents: Recommendations from the Children's Oncology Group CML Working Group. Pediatr Blood Cancer 2019;66(9):e27827.

Castagnetti F, Gugliotta G, Baccarani M, Breccia M, Specchia G, Levato L, et al. Differences among young adults, adults and elderly chronic myeloid leukaemia patients. Ann Oncol 2015;26(1):185–92.

Hijiya N, Schultz KR, Metzler M, Millot F, Suttorp M. Pediatric chronic myeloid leukaemia is a unique disease that requires a different approach. Blood 2016;127(4):392–7.

Bansal D, Shava U, Varma N, Trehan A, Marwaha RK. Imatinib has adverse effect on growth in children with chronic myeloid leukaemia. Pediatr Blood Cancer 2012;59(3):481–4.

Published

2022-06-24