Article citationsMore >>

Lindhorst SM, Lopez RD, Sanders RD. An Unusual Presentation of Chronic Myelogenous Leukemia: A Review of Isolated Central Nervous System Relapse. J Natl Compr Canc Netw. 2013; 11(7): 745-749.

has been cited by the following article:

Article

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

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


American Journal of Medical Case Reports. 2016, Vol. 4 No. 4, 126-129
DOI: 10.12691/ajmcr-4-4-4
Copyright © 2016 Science and Education Publishing

Cite this paper:
Ali Kutlucan, Mehmet Daglı, Leyla Kutlucan, Seher Kır, Abdulkadir Basturk, Ceyhan Ugurluoglu, Hasan Acar, Mehmet Sozen, 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.

Correspondence to: Ali  Kutlucan, Department of Internal Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey. Email: dralikutluca@gmail.com

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