The Clinical Analysis Of Five Cases With Chronic Myelogenous Leukemia With Thrombocythemia Onset

Objective:To analyse the clinical manifestation and the laboratoryfeatures of the patients of chronic myelogenous leukemia withthrombocythemia onset,and explore the diagnosis and therapeuticeffective.Methods:Retrospectively analyze and review five cases with chronicmyelogenous leukemia with thrombocythemia onset from the FirstAffiliated Hospital of guangxi medical university from2007to2012.Theclinical features and the therapeutic effect of them were analysed.Results:1.All patients are only thrombocythemia onset.2.Physicalexamination did not touch the spleen.3.The blood routine test showedsignificantly increased platelet(>1000×109/L),WBC was normal or mildlyincreased, immature cells were not discovered in leukocyte differentialcount.4.Bone marrow showed in megakaryocyte increasedobviously,normal granulopoiesis having normal maturation, normalerythropoiesis,neutrophil alkaline phosphatase (NAP) normal or slightincreased5.All the patients have the Ph chromosome and BCR-ABL fusion gene.6.Imatinib treatment be used in all patients,4cases achievedcomplete molecular response (CMR), of which1patient can not tolerateimatinib,after by using nilotinib,achieved CMR.Another patient can’ttolerate imatinib and nilotinib, still in chronic period.7.All patients werestill at follow-up, the longest follow-up is84month, the shortest for23months, all patients were progression-free survival.Conclusion:1.The platelet significantly increased as the startingperformance of CML patients, such as lack of classic clinical features ofCML, hematology and marrow cytology, easily misdiagnosed as ET.2.All patients with thrombocytosis should be detected Ph chromosome andBCR-ABL fusion gene.3.The patients of CML onset with significantthrombocythaemia, while lack of classic clinical features of CML, wasthe early stage of CML.