In non-blastic phase of chronic myelogenous leukemia(CML), thrombotic or
hemorrhagic complication may sometimes be accompanied, which occur spontaneously or
during surgical or dental procedure. The authors observed bleeding complications in
non-blastic phase of CML from January, 1980 to December, 1988 and their clinical
findings were analysed.
1. The bleeding complications were observed in 12.2% (9 cases) among 74 cases of
non-blastic phase of CML. Age distribution was between 20 and 59(median 41) years,
and male to female ratio was 81. The bleeding occurred concurrently with diagnosis of
CML in 6 cases.
2. The bleeding sites and its character were as follows : soft tissue hematoma (4
cases) which occurred spontaneously at thigh and buttock, axillar and scapular area, and
UGI bleeding of unknown cause(4 cases), and retinal hemorrhage(1 case).
3. On diagnosis of bleeding, 6 cases revealed thrombocytosis, among which 1 case
showed platelet count over 1,000,000/㎣.
4. Platelet aggregation function test was abnormal in 2 of 4 cases.
5. Surgical intervention was performed in 3 cases which included aspiration, and
incision & drainage in 2 cases, and bleeder ligation after gastronomy in 1 case.
Chemotherapy was concomittently given in 7 cases with the requirement of platelet
transfusion (apheresis) only in 2 cases. In 8 evaluable patients, bleeding was well
controlled without its related mortality.
Based upon the above results, bleeding itself in CML was manageable and
considerations on thorough diagnostic approaches and adequate therapeutic stratiges
would be required.
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