Insidious Onset of Chronic Myeloid Leukemia in a Longstanding Case of Chronic Immune Thrombocytopenia: A Rare Entity

Abstract

Aim: To present a case of an unusual association of development of chronic myeloid leukemia (CML) in a longstanding case of chronic immune thrombocytopenia with the help of lab investigations. Methodology: The peripheral blood smear slides were stained by using Leishman stain and observed under microscope. BCR ABL 1 was done by quantitative real time polymerase chain reaction (RT-PCR). Presentation of Case: We present a peculiar case that forms a link between the two independent diagnoses. This case highlights a 51-year-old woman on treatment for chronic ITP who was subsequently diagnosed with CML during follow-up. Discussion: The combination of series of events following the unresponsiveness of thrombocytopenia to Eltrombopag which was well-controlled over the years and a sudden uneventful rise in the total white blood cell count led to the suspicion of myeloproliferative disorder. Further bone marrow examination and molecular studies confirmed the diagnosis of chronic myeloid leukemia (CML). Conclusion: Thereby, we emphasize that survival rate can be improved by early identification and by suspecting clonal disorders as a differential diagnosis along with timely management of the condition in an early stage.