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Annals of Hematology

Ischemic stroke as a presenting feature of promyelocytic blast phase in chronic myeloid leukemia – an uncommon presentation: a case report and literature review in the post imatinib era

Published in:
Authors
Swapnil Tripathi
Vinu Balraam K. V.
Amiya Ranjan Nayak
Richa Chauhan
Pradeep Kumar
Jasmita Dass
Priyanka Naranje
Mukul Aggarwal
Published in
Annals of Hematology | Issue 12/2024

Abstract

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm (MPN characterized by reciprocal translocation in the ABL1 and BCR region of chromosomes 9 and 22 respectively. Progression to the blast phase in chronic myeloid leukemia results in a poorer prognosis. It can be of either myeloid, lymphoid or a mixed lineage. Progression to the promyelocytic blast phase is very rare, and there are no evidence-based guidelines for its management. Thrombosis in CML is not well defined. Thrombosis can be seen in patients with acute promyelocytic leukemia (APL) with venous thrombosis (VTE) being more common than arterial thrombosis. Ischemic stroke as the presenting feature of blast phase progression in CML is extremely rare. We report a case of CML who presented to us with acute ischemic stroke and subsequently was diagnosed as CML transformed to the promyelocytic blast phase. She was successfully treated with dasatinib along with all-trans retinoic acid (ATRA) and arsenic trioxide (ATO).
Title
Ischemic stroke as a presenting feature of promyelocytic blast phase in chronic myeloid leukemia – an uncommon presentation: a case report and literature review in the post imatinib era
Authors
Swapnil Tripathi
Vinu Balraam K. V.
Amiya Ranjan Nayak
Richa Chauhan
Pradeep Kumar
Jasmita Dass
Priyanka Naranje
Mukul Aggarwal
Publication date
16-10-2024
Publisher
Springer Berlin Heidelberg
Published in
Annals of Hematology / Issue 12/2024
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI
https://doi.org/10.1007/s00277-024-06044-9
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Image Credits
MRI of patient with stroke as presenting feature of CML/© 2024, Swapnil Tripathi et al, under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature, Ann Hematol, Colon cancer illustration/© (M) KATERYNA KON / SCIENCE PHOTO LIBRARY / Getty Images, CAR T-cell attacking cancer cells/© LoveLive/stock.adobe.com