Chronic Myeloid Leukemia With Polycythemia As The First Manifestation:a Case Report And Literature Review

Objective:To improve the understanding of the diagnosis and treatment of chronic myeloid leukemia(CML)with elevated erythrocytes as the first manifestation,so as to avoid missed diagnosis and misdiagnosis in clinical diagnosis and treatment.Methods:A case report of a CML patient admitted to the First Affiliated Hospital of Guangxi Medical University with polycythemia as the first manifestation was analyzed for its clinical manifestations and laboratory characteristics,and related literature was reviewed.Results:1.This patient started with polycythemia,excluding relative and secondary polycythemia,and met the diagnostic criteria of polycythemia vera(PV)in 2016,but the patient was positive for Ph chromosome and BCR-ABL fusion gene,which was also in line with the diagnostic criteria of CML in 2016,and was finally diagnosed as CML.2.After imatinib treatment,this patient achieved complete hematological and molecular reactions within half a year.Conclusion:1.Patients with polycythemia,after finishing the detection of erythropoietin(EPO),JAK2V617 F mutation and JAK2exon12 mutation and after excluding relativity and secondary polycythemia.No matter whether they can be diagnosed as PV or not,it is recommended to detect related tests of CML such as Ph chromosome and BCR-ABL fusion gene at the same time in order to rule out CML and to avoid clinical misdiagnosis and missed diagnosis.2.Imatinib is effective for CML patients with polycythemia as the first manifestation.