Multiple myeloma preceding the development of chronic myelogenous leukemia.
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.
Nitta
M
M
Second Department of Internal Medicine, Nagoya City University Medical School, Japan.
Tsuboi
K
K
Yamashita
S
S
Kato
M
M
Hayami
Y
Y
Harada
S
S
Komatsu
H
H
Iida
S
S
Banno
S
S
Wakita
A
A
Ueda
R
R
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
D012334:RNA, Neoplasm; D016044:Fusion Proteins, bcr-abl