Chronic Myeloid Leukemia (CML) Complicated by Mixed Malaria Infection- An Unusual Presentation
Keywords:
Chronic Myeloid Leukemia (CML), Plasmodium vivax, Plasmodium falciparum, Thrombocytopenia.Abstract
Objective: To report an unusual case of Chronic Myeloid Leukemia (CML) undergoing chemotherapy
complicated by co- infection with Plasmodium vivax and Plasmodium falciparum.
Case presentation: A 31 years Kashmiri male who was a known case of Philadelphia positive Chronic Myeloid
Leukemia and on chemotherapy for last1 year, presented with high grade fever, left flank pain, vomiting and
one episode of epistaxis. The oncologist suspected CML progressing to Accelerated phase or chemotherapeutic
drug (Tasigna) associated adverse effects leading to thrombocytopenia. He was diagnosed with mixed malarial
infection based on positive blood smear and bone marrow aspirate showing gametocytes of both Plasmodium
Vivax and Plasmodium Falciparum. Patient was treated successfully with anti malarial drugs and showed
marked improvement in platelet count.
Conclusion: It is suggested that malaria should be considered as a complicating factor in the patients of
hematological malignancies or those on chemotherapy in form of fever or thrombocytopenia, especially in
malaria- endemic areas.
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