抄録
A case of chronic myelocytic leukemia (CML) associated with miliary tuberculosis was reported. The patient was a 61-year-old male who had been diagnosed as CML and was treated with Myleran from Nov. 1976 to May 1977 at another hospital. Since May 1977 he began to have continuous high fever, and generalized red eruption appeared after the treatment with antibiotics. In June 1977, he was transferred to our ward, and miliary tuberculosis was incidentally found by the bone marrow aspiration (clot section) and the biopsy of the supraclavicular lymph node. At that time, there were no typical hematologic signs of CML, such as leukocytosis and reduced neutrophil alkaline phospatase (LAP) activity. Gradually pancytopenia became evident and high fever continued for 6 months in spite of antituberculous therapy. In Dec. 1977, high fever subsided and his general condition and peripheral blood picture were improved. In Oct. 1978, leukocyte count was increased up to 126,100/mm3 with markedly low LAP score. The bone marrow showed myeloid hyperplasia with positive Philadelphia chromosome. Although the prognosis of CML associated with miliary tuberculosis has been regarded to be very poor, this patient is still alive under the treatment with Myleran and antituberculous drugs.
