| Min Fengling,Zhai Lijia,Zhou Wei,Gao Xiaohui,Zhang Lina.. Two cases of chronic myelomonocytic leukemia combined with monoclonal gammopathy of undetermined significance and a literature review. Oncol Transl Med, 2017, 3: 41-46. |
| Two cases of chronic myelomonocytic leukemia combined with monoclonal gammopathy of undetermined significance and a literature review |
| Received:October 07, 2016 Revised:February 23, 2017 |
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| KeyWord:myeloproliferative neoplasms (MPN); myelodysplastic syndrome (MDS); monoclonal gammopathy of undetermined significance (MGUS) |
| Author Name | Affiliation | E-mail | | Min Fengling | Department of Hematology, The Affiliated Hospital of Yangzhou University, The First People's Hospital, Yangzhou 225001, China | 1014121694@qq.com | | Zhai Lijia | Department of Hematology, The Affiliated Hospital of Yangzhou University, The First People's Hospital, Yangzhou 225001, China | zhailijia@sina.com | | Zhou Wei | Department of Hematology, The Affiliated Hospital of Yangzhou University, The First People's Hospital, Yangzhou 225001, China | zhangj@sina.com | | Gao Xiaohui | Department of Hematology, The Affiliated Hospital of Yangzhou University, The First People's Hospital, Yangzhou 225001, China | hmlygxh@163.com | | Zhang Lina. | Department of Hematology, The Affiliated Hospital of Yangzhou University, The First People's Hospital, Yangzhou 225001, China | zhanglina0512@163.com |
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| Abstract: |
| To describe myelodysplastic syndrome (MDS)/myeloproliferative neoplasm (MPN) combined with
monoclonal gammopathy of undetermined significance (MGUS) in order to investigate the potential
association between these 2 diseases. Two cases of confirmed chronic myelomonocytic leukemia (CMML)
combined with MGUS were reported. In addition, prior publications of cases with combined MDS or MPN
with MGUS were reviewed. The first case was of a 77-year-old man whose routine blood tests showed
abnormal hemogram results. The diagnosis was CMML combined with IgM monoclonal gammopathy,
and the disease course was 4 years. The CMML gradually progressed and the patient presented with
anemia, thrombocytopenia, autoimmune hemolysis, and an increase in the number of immature cells in
the bone marrow. Although the MGUS caused fluctuations in the concentrations of IgM, no IgM-associated
organ damage was observed. Eventually, this patient died from a lung infection. The second case was
of a 78-year-old man who sought treatment because of fever and a cough. An increase in the number of
monocytes was discovered in the peripheral blood. Bone marrow smear results suggested obvious active
granulocytes and an increase in the percentages of promyelocytes, myelocytes, and metamyelocytes.
Unhealthy granulocytes and immature monocytes could also be observed, and the percentage of monocytes
was increased. In addition, serum IgG levels were increased, and immunofixation electrophoresis results
showed IgG-κ type M proteins. The diagnosis was CMML combined with IgG monoclonal gammopathy.
These diseases were stable and follow-up was conducted for 1 year after diagnosis. The cases in this
study combined with those that were reviewed in the relevant literature indicate that the presence of these
2 diseases in the same patient might not be a coincidence. The development of the 2 diseases in case 1
was different, and we speculate that they might have had different clonal origins. Whether CMML is a risk
factor for MGUS and the role of clonal plasma cells in the occurrence and development of MDS and MDS/
MPN requires further studies on a larger number of cases. |
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