An Uncommon Presentation of Chronic Myeloid Leukemia: Osteolytic Bone Lesion as the Initial Manifestation

Authors

  • Razan Hayati Zulkeflee Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia; Hospital USM, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia https://orcid.org/0000-0003-2760-0703
  • Mohd Nazri Hassan Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia; Hospital USM, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia https://orcid.org/0000-0003-4975-2038
  • Zefarina Zulkafli Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia; Hospital USM, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia https://orcid.org/0000-0003-2029-2234
  • Noor Haslina Mohd Noor Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia; Hospital USM, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia
  • Azlan Husin Hospital USM, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia; Department of Internal Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia https://orcid.org/0000-0003-0899-0443
  • Abu Dzarr Abdullah Hospital USM, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia; Department of Internal Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia
  • Shafini Mohamed Yusoff Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia; Hospital USM, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia https://orcid.org/0000-0001-8950-5715
  • Marini Ramli Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia; Hospital USM, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia https://orcid.org/0000-0002-9104-7511
  • Rosnah Bahar Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia; Hospital USM, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia https://orcid.org/0000-0003-4276-7288
  • Wan Suriana Wan Abd Rahman Department of Internal Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia; School of Dental Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia
  • Norzaliana Zawawi Hospital USM, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia; School of Dental Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia; Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia https://orcid.org/0000-0003-3640-0383

DOI:

https://doi.org/10.15419/bmrat.v11i3.873

Keywords:

Chronic myeloid leukaemia, Myeloid sarcoma, Osteolytic lesion

Abstract

Background: Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm that typically occurs in the fifth and sixth decades of life with presentations usually confined to hematopoietic tissues—primarily blood, bone marrow, and spleen. However, primary presentation of CML as extramedullary involvement (osteolytic lesion) is extremely rare, occurring in less than 1% of cases.

Case Presentation: Here, we present a case of a 25-year-old male with chronic myeloid leukemia (CML), characterized by an atypical presentation of a femur fracture accompanied by an osteolytic lesion. The peripheral blood findings displayed typical features of CML, including leukocytosis with a full spectrum of myeloid maturation stages, basophilia, and occasional blasts. The diagnosis of CML in the blastic phase was confirmed by the presence of the Philadelphia chromosome and the BCR-ABL1 fusion gene (b2a2), as well as features of myeloid sarcoma in the tissue biopsy.

Conclusion: Given the aggressive nature of granulocytic sarcoma and its impact on prognosis, early recognition and intervention are essential to mitigate complications and improve patient outcomes.

Author Biography

  • Mohd Nazri Hassan, Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia; Hospital USM, Universiti Sains Malaysia, 16150 Kubang Kerian Kelantan, Malaysia

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Published

2024-03-31

Issue

Section

Case report

How to Cite

An Uncommon Presentation of Chronic Myeloid Leukemia: Osteolytic Bone Lesion as the Initial Manifestation. (2024). Biomedical Research and Therapy, 11(3), 6276-6281. https://doi.org/10.15419/bmrat.v11i3.873

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