Chronic myelomonocytic leukemia (CMML)-0 with pleural effusion as first manifestation: A case report.

Abstract

RATIONALE:

Extramedullary invasion of chronic myelomonocytic leukemia (CMML) usually occurs in the liver, spleen, and lymph nodes, while the pleural infiltration of CMML is rare. The presence of pleural effusion is usually associated with uncontrolled leukocytosis and increased monocytes.

PATIENT CONCERNS:

Here we reported a rare case of CMML-0 with pleural effusion as the first manifestation in a 44-year-old woman. The pleural effusion was caused by blasts infiltration confirmed by the flow cytometer and the pleural biopsy.

DIAGNOSES:

CMML with pleural invasion.

INTERVENTIONS:

The patient was treated with azacitidine 75 mg/m d for 2 cycles, followed by daily oral intake of hydroxyurea (500 mg/d).

OUTCOMES:

Pleural effusion was resolved and chest pain was relieved.

LESSONS:

The current case indicated that leukemic infiltration into pleura could occur despite mild leukocytes, while demethylation may be an effective therapy.

• Authors: Lianbo Hu, Bingrong Zheng, Lijuan Fu, Meiwei Hu
• Journal: Medicine (Medicine (Baltimore)) Vol. 99 Issue 44 Pg. e23030 (Oct 30 2020) ISSN: 1536-5964 [Electronic] United States
• PMID: 33126392 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Antineoplastic Agents
• Azacitidine
• Hydroxyurea

Topics

• Adult
• Antineoplastic Agents (administration & dosage, therapeutic use)
• Azacitidine (administration & dosage, therapeutic use)
• Diagnosis, Differential
• Drug Therapy, Combination
• Female
• Humans
• Hydroxyurea (administration & dosage, therapeutic use)
• Leukemia, Myelomonocytic, Chronic (complications, diagnosis, pathology)
• Lung Neoplasms (complications, diagnosis, diagnostic imaging, secondary)
• Pleural Effusion (etiology)
• Tomography, X-Ray Computed