title: Chronic myelomonocytic leukemia developed 2 years after the onset of immune thrombocytopenic purpura like syndrome.
abstract: An 80-year old man was diagnosed as having immune thrombocytopenic purpura based on epistaxis, purpura and by the platelet count 8 x 10(9)/l. Prednisolone and gamma globulin were administered and the platelet count had been kept around 50 x 10(9)/l during his follow up. Two years from the onset of immune thrombocytopenic purpura he was admitted because of leukocytosis (79 x 10(9)/l with 79% monocytes), anemia and thrombocytopenia. Hypercellular bone marrow with dysplasia of three lineages was observed. In the bone marrow cytogenic analysis, a -6, clonal cytogenic abnormality was observed. 45XY, der(6), t(6;6)(q16;q23). He was diagnosed as having chronic myelomonocytic leukemia. This is a difficult case in which it was diagnosed as refractory thrombocytopenia as a subgroup of myelodysplastic syndrome, rather than immune thrombocytopenic purpura. which might have preceded the development of chronic myelomonocytic leukemia.
authors: Department of Hematology, Gülhane Military Medical Academy, Etlik, Ankara, Turkey. aural@gata.edu.tr
authors: A U
authors: AU
authors: Ural
authors: K
authors: K
authors: Kaptan
authors: F
authors: F
authors: Avcu
authors: S
authors: S
authors: Güran
authors: C
authors: C
authors: Beyan
authors: O
authors: O
authors: Durmuş
authors: A
authors: A
authors: Yalçin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D015477:Leukemia, Myelomonocytic, Chronic / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D011696:Purpura, Thrombocytopenic / Q000150:complications*; D013577:Syndrome