Pleural effusion in 4 patients with chronic myelomonocytic leukemia (CMML) is described in this report. According to the literature, pleural effusion in CMML is a poorly understood and rare occurrence. Two of our patients presented with pleural effusion as an initial symptom while the other 2 developed it during the course of the disease. In only 1 patient was the pleural effusion due to leukemic infiltration while in the other 3 it was a reactive phenomenon. Peripheral lymphadenopathy was observed only in the former patient who died of acute leukemia. After prednisolone therapy the pleural effusions resolved in the other 3 patients.

Keywords:
Chronic myelomonocytic leukemia, Pleural effusion
1.
Bennett JM, Catovsky D, Daniel MT, Flandrin C, Galton DAC, Gralnick HR, Soultan CR: The French-American-British (FAB) Cooperative Group: Proposals for the classification of the myelodysplastic syndromes. Br J Haematol 1982;51:189–199.
2.
Tefferi A, Hoagland HC, Therneau TM, Pierre RV: Chronic myelomonocytic leukemia: Natural history and prognostic determinants. Mayo Clin Proc 1989;64:1246–1254.
3.
Bourantas K, Christou L, Tsiara S, Galanakis E, Sirou M: Follow-up of eighteen patients with chronic myelomonocytic leukemia. J Exp Clin Cancer Res 1995;14:321–326.
4.
Michaux JL, Martial P: Chronic myelomonocytic leukemia (CMML) and myelodysplastic or myeloproliferative syndrome. Leuk Lymphoma 1993;9:35–41.
5.
Bubbley C, Come P, MacDougall D, Thurner R, Goldberg J: Pericardial tamponade associated with myeloid metaplasia. Am J Hematol 1983;14:185–188.
6.
Shih LY, Lin FC, Kuo TT: Cutaneous and pericardial extramedullary hematopoiesis with cardiac tamponade in chronic myeloid leukemia. Am J Clin Pathol 1988;89:693–697.
7.
Mufti GJ, Oscier DG, Hamblin TJ, Nightingale A, Parlow S: Serous effusions in monocytic leukaemias. Br J Haematol 1984;58:547–552.
8.
Manoharan A: Malignant pleural effusion in chronic myelomonocytic leukemia. Thorax 1991;46:461–462.
9.
Mani S, Duffy TP: Pericardial tamponade in chronic myelomonocytic leukemia. Chest 1994;106:967–970.
10.
Enright H, Jacob HS, Vercellotti G, Howe R, Belzer M, Miller W: Paraneoplastic autoimmune phenomena in patients with myelodysplastic syndromes: Response to immunosuppressive therapy. Br J Haematol 1995;91:403–408.
11.
Billstrom R, Johansson H, Johansson B, Mitelman F: Immune-mediated complications in patients with myelodysplastic syndromes – Clinical and cytogenetic features. Eur J Haematol 1995;58:42–48.
12.
Oscier DG, Worsely A, Hamblin TJ, Mufti GJ: Treatment of chronic myelomonocytic leukemia with low-dose etoposide. Br J Haematol 1989;72:468–471.
13.
Malammou-Mitsi VD, Stavridis C, Tsiara S, Bourantas K: Malignant pleural effusion as the initial manifestation in chronic lymphocytic leukemia. J Exp Clin Cancer Res 1996;15/2:211–213.
14.
Bourantas K, Malamou-Mitsi VD, Christou L, Filippidou S, Drosos AA: Cutaneous vasculitis as the initial manifestation in acute myelomonocytic leukemia. Ann Intern Med 1994;121:942–944.
15.
Butler RC, Thompson JM, Keat AC: Paraneoplastic rheumatic disorders: A review. J R Soc Med 1990;126:61–65.
16.
Cox NH, Lawrence CM, Langtry JA, Ive FA: Dermatomyositis. Disease associations and an evaluation of screening investigations for malignancy. Arch Dermatol 1990;126:61–65.
17.
Rosen AM, Haines K, Tallman MS, Hakiman D, Ramsey-Goldman R: Rapidly progressive cutaneous vasculitis in a patient with chronic myelomonocytic leukemia. Am J Hematol 1995;50:310–312.
1998
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.