Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2022; 10(14): 4698-4703
Published online May 16, 2022. doi: 10.12998/wjcc.v10.i14.4698
Development of plasma cell dyscrasias in a patient with chronic myeloid leukemia: A case report
Na Zhang, Ting-De Jiang, Shu-Hua Yi
Na Zhang, Ting-De Jiang, Department of Hematology, People’s Hospital of Deyang, Deyang 618000, Sichuan Province, China
Shu-Hua Yi, Hematology Hospital of the Institute of Hematology, Chinese Academy of Medical Sciences, Tianjin 300020, China
Author contributions: Zhang N, Jiang TD and Yi SH designed and wrote this manuscript; Zhang N revised the manuscript; all authors reviewed and approved the final version to be published.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declared no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shu-Hua Yi, MD, Attending Doctor, Hematology Hospital of the Institute of Hematology, Chinese Academy of Medical Sciences, No. 288 Nanjing Road, Tianjin 300020, China. 3378465425@qq.com
Received: December 23, 2021
Peer-review started: December 23, 2021
First decision: January 25, 2022
Revised: February 21, 2022
Accepted: March 17, 2022
Article in press: March 17, 2022
Published online: May 16, 2022
Abstract
BACKGROUND

Chronic myeloid leukemia (CML) is a clonal hematopoietic stem cell disorder. Plasma cell dyscrasias are a rare heterogeneous group of hematological disorders. The co-occurrence of CML and plasma cell dyscrasias in the same patient is an extremely rare incident and has been reported in several cases in the literature.

CASE SUMMARY

In the present report, we described a rare case of the co-occurrence of CML and plasma cell dyscrasias in a 48-year-old man, and we discussed the reason why monoclonal gammopathy of undetermined significance progressed to smoldering multiple myeloma and eventually to multiple myeloma while being treated with dasatinib for CML. The tyrosine kinase inhibitor treatment and cytogenetic change may contribute to this phenomenon, and clonal hematopoiesis of indeterminate potential may lead to both CML and multiple myeloma cells in a patient. Future studies are warranted to further explain the hidden reasons.

CONCLUSION

This case highlights that gene translocation may contribute to initiation and sustainability of clonal proliferation. Moreover, the treatment with tyrosine kinase inhibitor and cytogenetic change may contribute to progression from monoclonal gammopathy of undetermined significance to smoldering multiple myeloma and eventually to multiple myeloma.

Keywords: Chronic myeloid leukemia, Plasma cell dyscrasias, Multiple myeloma, Tyrosine kinase inhibitor, Translocation, Case report

Core Tip: Here we describe a patient with chronic myeloid leukemia complicated with plasma cell dyscrasias receiving dasatinib. He developed monoclonal gammopathy of undetermined significance that progressed to smoldering multiple myeloma and eventually to multiple myeloma. This case highlights that gene translocation may contribute to initiating and sustaining clonal proliferation. Tyrosine kinase inhibitors and cytogenetic change may lead to the progression.