Hu L, Zheng B, Fu L, Hu M. Chronic myelomonocytic leukemia (CMML)-0 with pleural effusion as first manifestation: A case report.
Medicine (Baltimore) 2020;
99:e23030. [PMID:
33126392 PMCID:
PMC7598868 DOI:
10.1097/md.0000000000023030]
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Abstract
RATIONALE
Extramedullary invasion of chronic myelomonocytic leukemia (CMML) usually occurs in the liver, spleen, and lymph nodes, while the pleural infiltration of CMML is rare. The presence of pleural effusion is usually associated with uncontrolled leukocytosis and increased monocytes.
PATIENT CONCERNS
Here we reported a rare case of CMML-0 with pleural effusion as the first manifestation in a 44-year-old woman. The pleural effusion was caused by blasts infiltration confirmed by the flow cytometer and the pleural biopsy.
DIAGNOSES
CMML with pleural invasion.
INTERVENTIONS
The patient was treated with azacitidine 75 mg/m d for 2 cycles, followed by daily oral intake of hydroxyurea (500 mg/d).
OUTCOMES
Pleural effusion was resolved and chest pain was relieved.
LESSONS
The current case indicated that leukemic infiltration into pleura could occur despite mild leukocytes, while demethylation may be an effective therapy.
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