title: Multiple myeloma preceding the development of chronic myelogenous leukemia.
abstract: A case of a 70-year-old man who first developed multiple myeloma and then chronic myelogenous leukemia (CML) within a 3-year period is documented. The patient, with monoclonal hypergammopathy, was diagnosed with smoldering myeloma with IgG-kappa and Bence Jones protein kappa paraproteinemia. No chemotherapy was given for the myeloma until progressive leukocytosis developed after approximately 3 years. This was found to be due to Philadelphia chromosome positive CML. A reverse transcription-polymerase chain reaction assay did not reveal BCR/ABL mRNAs when the myeloma was first diagnosed. The occurrence of 2 distinct hematologic malignancies in the same patient suggests either a different clonal evolution from a common pluripotent malignant stem cell since the CML stem cell also involves the B-lymphoid lineage, a coincident complication of the 2 hematological malignancies, or the coexistence of 2 distinct malignancies due to the same genetic background and/or exposure to similar carcinogenic agents. The literature provides support for the existence of a relationship between multiple myelomas and CML.
authors.affiliation: Second Department of Internal Medicine, Nagoya City University Medical School, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Nitta
authors.forename: K
authors.initials: K
authors.lastname: Tsuboi
authors.forename: S
authors.initials: S
authors.lastname: Yamashita
authors.forename: M
authors.initials: M
authors.lastname: Kato
authors.forename: Y
authors.initials: Y
authors.lastname: Hayami
authors.forename: S
authors.initials: S
authors.lastname: Harada
authors.forename: H
authors.initials: H
authors.lastname: Komatsu
authors.forename: S
authors.initials: S
authors.lastname: Iida
authors.forename: S
authors.initials: S
authors.lastname: Banno
authors.forename: A
authors.initials: A
authors.lastname: Wakita
authors.forename: R
authors.initials: R
authors.lastname: Ueda
mesh_terms: D000368:Aged; D001402:B-Lymphocytes; D016044:Fusion Proteins, bcr-abl / Q000235:genetics*; D006412:Hematopoietic Stem Cells / Q000166:cytology; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000235:genetics / Q000473:pathology*; D008297:Male; D009101:Multiple Myeloma / Q000235:genetics / Q000473:pathology*; D010677:Philadelphia Chromosome; D012334:RNA, Neoplasm / Q000032:analysis
chemical_list: D012334:RNA, Neoplasm; D016044:Fusion Proteins, bcr-abl