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• W1984078260 abstract "DR BURNS: Mrs P is a 41-year-old woman with chronic myelogenous leukemia (CML). She previously worked as a hairdresser but has not worked for several months. Mrs P lives with her husband and children. She has commercial insurance. For a number of years, Mrs P noted that she felt fatigued and had headaches. She sought medical care, but no explanation was found. In June 2002, she went to a new primary care physician and was found to have a white blood cell count of 58 10/μL, hematocrit of 41.4%, and a platelet count of 211 10/μL. There were 51 polys, 2 monocytes, 1 eosinophil, 1 promyelocyte, 13 myelocytes, 14 bands, and 5 metamyelocytes. A bone marrow biopsy was performed and she was found to have a myeloproliferative disorder; cytogenetic testing showed classic Philadelphia chromosome (Ph). Mrs P was seen at another medical center and imatinib mesylate (Gleevec; Novartis, East Hanover, NJ) was recommended. After starting imatinib (400 mg/d), she developed severe occipital headaches and an abdominal rash. The drug was stopped and her symptoms improved; however, her white blood cell count rose to higher than 120 10/μL. She was subsequently restarted on a lower dose of imatinib (200 mg/d) with a plan to slowly increase the dose to 400 mg/d. She tolerated this regimen better, although she continued to note ongoing occipital headaches and fatigue. Her white blood cell count improved to 88 10/μL. Mrs P has a past medical history significant for kidney stones and migraines and a past surgical history significant for an appendectomy and hysterectomy. Her only current medication is imatinib mesylate (400 mg/d). She is allergic to penicillin and sulfa. She quit smoking in October 1994, and she does not drink alcohol. Mrs P recently sought a second opinion and an allogeneic transplantation was recommended. She decided to proceed with the transplant as she believed that it offered a reasonably good chance for cure and because she felt that she could neither afford imatinib for the long-term nor tolerate its adverse effects. Mrs P and her siblings underwent histocompatibility testing and were not a match. She has considered her options and is planning a matched, unrelated donor stem cell transplantation." @default.
• W1984078260 created "2016-06-24" @default.
• W1984078260 creator A5054037976 @default.
• W1984078260 date "2003-08-27" @default.
• W1984078260 modified "2023-09-27" @default.
• W1984078260 title "A 41-Year-Old Woman With Chronic Myelogenous Leukemia" @default.
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• W1984078260 doi "https://doi.org/10.1001/jama.290.8.1083" @default.
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