Chronic myeloid leukaemia with generalized lymphadenopathy – a high risk category

Chronic myeloid leukaemia (CML) presenting with generalized lymphadenopathy is an uncommon manifestation of CML. Lymphadenopathy in these patients could be due to extramedullary involvement by myeloid cells with all stages of maturation, blast infiltration, co-existing lymphoproliferative disorder or reactive lymphadenopathy. We report a case of a 38-year-old male with CML in chronic phase and generalized lymphadenopathy at diagnosis. He transformed to blast crisis within 14 weeks of diagnosis despite tyrosine kinase inhibitor (TKI) therapy. This case indicates that CML patients with lymphadenopathy are at high risk of disease progression and early blast transformation and therefore candidates for aggressive treatment.