Skin infiltration associated with chronic myelomonocytic leukaemia

Abstract

Chronic myelomonocytic leukemia (CMML) is typically associated with a prolonged clinical course and is not usually very responsive to chemotherapeutic intervention. Skin infiltration has not been recognized previously as a feature of this illness. Four patients were seen recently with CMML, who during the course of their illness developed marked skin infiltration. While sensitivity to chemotherapy could be demonstrated in the peripheral blood cell population, skin infiltration was quite resistant to treatment. Skin infiltration heralded a more aggressive phase of the disease although no discernible change in morphology, cytochemistry or membrane marker analysis of the leukemic cell population could be demonstrated in 3 of the patients studied; 1 patient, however, transformed to an acute leukemia shortly thereafter.