Chronic Myelomonocytic Leukemia-Induced Overt Acute Leukemia with Impairment of Mastication due to Leukemia Cell Infiltration in the Tongue that was Improved by Chemotherapy

摘要

The patient was a 68-year-old man under observation following blood transfusion for anemia. The patient was referred to the hematology & oncology department of our hospital, with suspected acute myelogenous leukemia or myelodysplastic syndrome-induced overt leukemia, and was urgently admitted. Bone marrow aspiration was performed, and chronic myelomonocytic leukemia (CMML) was diagnosed. WBC count increased to 59400/muL within a short period after admission, during which time the tongue swelled and caused dysarthria and impaired mastication. Oral hydroxycarbamide administration (2000 mg) was immediately initiated, and conversation became possible after 7 days. The patient was thereafter treated as an outpatient, but edema appeared in the bilateral limbs, suggesting leukemia cell infiltration.