THROMBOTIC MICROANGIOPATHY IN A PATIENT WITH CHRONIC MYELOGENOUS LEUKEMIA ON HYDROXYUREA

We describe the case of a 57-year-old woman with chronic myelogenous l eukemia who was on hydroxyurea and developed a fatal thrombotic microa ngiopathy with renal, retinal and central nervous system involvement. There was no evidence of medullary or extramedullary leukemia transfor mation. Repeated examinations of the peripheral blood film revealed on ly minimal morphological changes of microangiopathic hemolysis. The di agnosis was made by postmortem examination of the kidneys, brain, meni nges and retina. The underlying etiology may have been a paraneoplasti c phenomenon of the chronic phase of CML or may have indicated the beg inning of transformation to an accelerated phase. A late side effect o f hydroxyurea therapy cannot be excluded.