Philadelphia-positive T-cell acute lymphoblastic leukemia with polymyositis, migratory polyarthritis and hypercalcemia following a chronic myeloid leukemia.
Transformation of chronic myeloid leukemia (CML) often results in acute myeloblastic or, less frequently, in precursor B-cell acute lymphoblastic leukemia (ALL). T-cell blast crisis is rare. Hypercalcemia has also been described as a rare complication of CML, but this usually occurs as a terminal event. Here we report a case of a 35-year-old woman who developed a CD4(+)/CD8(+) T-cell ALL 2 years after the diagnosis of a typical Ph(+) CML. Polymyositis and polyarthritis preceded by 4 months, and symptomatic hypercalcemia occurred just before blastic transformation, probably representing paraneoplastic manifestations of the disease.
Lima
M
M
Department of Clinical Hematology, Hospital Geral de Santo António, Rua D Manuel II, s/n, 4099-001 Porto, Portugal. mmc.lima@clix.pt
Coutinho
J
J
Bernardo
L
L
dos Anjos Teixeira
M
M
Casais
C
C
Canelhas
A
A
Queirós
L
L
Orfão
A
A
Justiça
B
B
D000328:Adult; D001168:Arthritis / Q000209:etiology*; D015496:CD4-Positive T-Lymphocytes / Q000473:pathology; D018414:CD8-Positive T-Lymphocytes / Q000473:pathology; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology*; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000150:complications* / Q000235:genetics* / Q000473:pathology; D010677:Philadelphia Chromosome; D017285:Polymyositis / Q000209:etiology*