Hodgkin Lymphoma in a Case of Chronic Myeloid Leukemia Treated with Tyrosine Kinase Inhibitors

Abstract

Chronic myeloid leukemia (CML) is characterized by increased and unregulated proliferation of granulocytic lineage in the bone marrow andpresence of these immature myeloid cells in the peripheral blood with presence of Philadelphia (Ph) chromosome. Tyrosine kinase inhibitorsare the most important drugs in the CML therapy and provide long disease-free survival. Due to the increased survival of CML patients withcontinual administration of these drugs, the chance of development of secondary malignancies may increase. The most common secondarymalignancies are prostate, colorectal and lung cancer, non-Hodgkin lymphoma, malignant melanoma, non-melanoma skin tumors and breastcancer. Herein, we are describing a rare case of Hodgkin lymphoma in a patient of CML after ten year of primary disease presentation. Hodgkinlymphoma in a known case of CML is very rare and further studies are also needed to know the pathogenic relationship between the two entitiesand to assess the risk of secondary Hodgkin lymphoma in CML patients treated with tyrosine kinase inhibitors. CML itself is a risk factor fordevelopment of solid cancers and hematologic malignancies. In addition, patients on chemotherapy are immune-compromised and may be atgreater risk of neoplasm driven by infectious agents such as Epstein-Barr virus.