Chronic myeloid leukemia with solitary extramedullary bone deposit: A unique presentation

Abstract

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm, characterized by a hematopoietic stem cell carrying BCR-ABLl fusion protein. Common sites of extramedullary deposits in CML are lymph nodes, bones, and central nervous system. We present a case of a 39-year-old male diagnosed case of CML who presented with extramedullary deposit in the right femur in spite of complete hematological remission and major molecular response on real-time quantitative reverse transcriptase polymerase chain reaction in the blood. Extramedullary deposit is almost always followed by hematological reemergence of disease and is considered as an early sign of disease in the bone marrow. Bone, lymph nodes, skin and soft tissues, and central nervous system are the common sites for extramedullary deposits in a case of CML. A thorough literature review revealed limited case reports on extramedullary deposits in a case of CML in major molecular response. Therefore, the possibility of being confronted with unusual signs and symptoms which could be indicative of extramedullary deposits should be kept in mind.

Keywords

• bcr-abl positive
• bone marrow
• chronic myeloid leukemia
• hematopoietic stem cells
• myeloproliferative disorders