American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: http://www.sciepub.com/journal/ajmcr Editor-in-chief: Apply for this position
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American Journal of Medical Case Reports. 2016, 4(4), 126-129
DOI: 10.12691/ajmcr-4-4-4
Open AccessCase Report

A Case of Relapsed Chronic Myeloid Leukemia Admitted with the Complaints of Paraplegia and Urinary Incontinence

Ali Kutlucan1, , Mehmet Daglı1, Leyla Kutlucan2, Seher Kır3, Abdulkadir Basturk1, Ceyhan Ugurluoglu4, Hasan Acar5, Mehmet Sozen1 and Kubra Turkay1

1Department of Internal Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey

2Department of Anesthesiology, Konya Training and Research Hospital, Konya, Turkey

3Department of Internal Medicine, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey

4Department of Pathology, Faculty of Medicine, Selcuk University, Konya, Turkey

5Department of Genetics, Faculty of Medicine, Selcuk University, Konya, Turkey

Pub. Date: April 26, 2016

Cite this paper:
Ali Kutlucan, Mehmet Daglı, Leyla Kutlucan, Seher Kır, Abdulkadir Basturk, Ceyhan Ugurluoglu, Hasan Acar, Mehmet Sozen and Kubra Turkay. A Case of Relapsed Chronic Myeloid Leukemia Admitted with the Complaints of Paraplegia and Urinary Incontinence. American Journal of Medical Case Reports. 2016; 4(4):126-129. doi: 10.12691/ajmcr-4-4-4

Abstract

Chronic myeloid leukemia (CML) is a clonal hematopoietic stem cell malignancy. In CML, extramedullary blastic crisis is a very rare condition in which the prognosis is even worse. Herein we presented a rare case of relapsed CML patient as blastic crisis with serious neurological symptoms because of central nervous system (CNS) infiltration. A 69-year-old male patient diagnosed with CML was admitted to hospital with complaints of weakness in legs, urinary incontinence, abnormal speech, and impaired vision. Deep tendon reflexes were bilaterally hypoactive in lower and upper extremities and Babinski reflex was negative. Immunophenotyping and cytological examination of CSF showed blastic cell infiltration. Also BCR-ABL mutation was positive in CSF and MR showed CNS involvement. So the patient diagnosed as “Myeloid blastic phase of CML with CNS involvement”. İmatinib therapy was replaced with dasatinib and intrathecal methotrexate, cytarabine and dexamethasone treatment was applied. Complaints of weakness, fatigue, urinary incontinence, leg weakness and inability to walk were completely resolved in three months. Extramedullary blastic crisis such as CNS involvement has been reported in a limited number in CML. Even if hematological and cytogenetic remission is provided, CML patients should be followed regularly. Any new clinical detail should be considered carefully and extramedullary involvement including CNS should be kept in mind.

Keywords:
chronic myeloid leukemia extramedullary blastic crisis dasatinib central nervous system infiltration

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