Abstract
Chronic myeloid leukemia (CML) is a hematologic malignancy driven by the BCR-ABL1 fusion gene, which results in the abnormal proliferation of myeloid cells. The disease
typically has two phases: chronic (CP) and blast crisis (BC). Extramedullary blast
crisis (EBC) in CML refers to the presence of blast cells in extramedullary sites,
irrespective of the blast proliferation occurring in the bone marrow. Renal infiltration
of blasts as the initial presentation of CML is exceedingly rare. We present a case
of a 51-year-old man with renal failure. Renal biopsy showed myeloperoxidase staining
blasts, with bone marrow in CP. Based on the presence of EBC, the patient was diagnosed
with CML in BC, despite the CP in the bone marrow, a rare occurrence that challenges
conventional diagnostic pathways.
Keywords
acute kidney injury - blast phase - chronic myeloid leukemia - chronic phase - extramedullary
blast crisis - tyrosine kinase inhibitors
