Published online May 26, 2023. doi: 10.12998/wjcc.v11.i15.3643
Peer-review started: February 16, 2023
First decision: March 28, 2023
Revised: April 7, 2023
Accepted: April 19, 2023
Article in press: April 19, 2023
Published online: May 26, 2023
Chronic myelomonocytic leukemia (CMML), a rare clonal hematopoietic stem cell disorder characterized by myelodysplastic syndrome and myeloproliferative neoplasms, has a generally poor prognosis, and easily progresses to acute myeloid leukemia. The simultaneous incidence of hematologic malignancies and solid tumors is extremely low, and CMML coinciding with lung malignancies is even rarer. Here, we report a case of CMML, with ASXL1 and EZH2 gene mutations, combined with non-small cell lung cancer (lung squamous cell carcinoma).
A 63-year-old male, suffering from toothache accompanied by coughing, sputum, and bloody sputum for three months, was given a blood test after experiencing continuous bleeding resulting from a tooth extraction at a local hospital. Based on morphological results, the patient was diagnosed with CMML and bronchoscopy was performed in situ to confirm the diagnosis of squamous cell carcinoma in the lower lobe of the lung. After receiving azacitidine, programmed cell death protein 1, and platinum-based chemotherapy drugs, the patient developed severe myelosuppression and eventually fatal leukocyte stasis and dyspnea.
During the treatment and observation of CMML and be vigilant of the growth of multiple primary malignant tumors.
Core Tip: A 63-year-old male, with a long history of heavy smoking, was diagnosed with chronic myelomonocytic leukemia (CMML), with additional sex combs-like and enhancer of zeste homolog 2 gene mutations, as well as non-small cell lung cancer (squamous cell carcinoma). However, no such mutations were found in the lung cancer tissue. In CMML patients, pulmonary manifestations are non-specific, and the rare presence of malignant tumors in the lungs poses challenges in diagnosis. After receiving azacitidine, programmed cell death protein 1, and platinum-based chemotherapy drugs, the patient developed severe myelosuppression and eventually fatal leukocyte stasis and dyspnea. Therefore, during treatment and observation of CMML, medical practitioners should pay attention to the occurrence and evolution of solid tumors such as lung cancer, and be vigilant of the growth of multiple primary malignant tumors.