title: [Appearance of a chronic myeloid leukemia in Waldenström's macroglobulinemia].
abstract: Philadelphia chromosome-positive chronic myeloid leukaemia (CML) developed three years after the diagnosis of Waldenström macroglobulinemia (WM) in a patient who had received chlorambucil and prednisone during this time. Treatment with busulphan was started and two and a half years later the died in blastic crisis. Six months before the blastic transformation of the leukaemia the amount of IgM, which remains stable (above normal values) along the chronic phase, initiates a decrease, reaching normal values in the phase of acute transformation. CML is a very rare second neoplasia in patients receiving anticancer drugs. The correlation between the decrease of IgM and the blastic crisis is very interesting. We do not find an explanation for this finding although similar observations have been described heralding the appearance of second neoplasias in WM, and one might speculate with a possible role of IgM in the control of chronic phase of the myeloid leukaemia or if the overgrowth of blastic cells could overwhelm the development of lymphoplasmacytoid cells.
authors.affiliation: Servico de Hematología, Hospital Virgen de la Arrixaca, Murcia.
authors.forename: M J
authors.initials: MJ
authors.lastname: Majado
authors.forename: C
authors.initials: C
authors.lastname: González García
authors.forename: M D
authors.initials: MD
authors.lastname: Marín-Blazquez
authors.forename: A
authors.initials: A
authors.lastname: Morales Lázaro
authors.forename: M
authors.initials: M
authors.lastname: Moreno Moreno
mesh_terms: D002066:Busulfan / Q000627:therapeutic use; D002699:Chlorambucil / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000188:drug therapy / Q000473:pathology; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D008258:Waldenstrom Macroglobulinemia / Q000188:drug therapy
chemical_list: D002699:Chlorambucil; D002066:Busulfan; D011241:Prednisone
vernacular_title: Aparición de una leucemia mieloide crónica en el curso de una macroglobulinemia de Waldenström.