Chronic myeloid leukemia coexisting with non-Hodgkin’s lymphoma: An uncommon presentation of bilineage hematological malignancy

The incidence of hematological malignancies is on the rise particularly in developing countries as a result of newer diagnostic technologies and skills. However, the coexistence of chronic myeloid leukemia (CML) and non-Hodgkin lymphoma (NHL) in a single patient simultaneously is extremely rare, with an overall incidence of less than 1%, while the majority of cases (66%) have sequential presentations. We report a 36-year old Nigerian man, who was diagnosed in our facility initially in chronic phase CML, but progressed through accelerated phase to blastic phase CML and was subsequently diagnosed with NHL within weeks of starting hydroxyurea. He also received cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisolone (CHOP) for the NHL. However, he subsequently succumbed to the disease. CML is a triphasic disease with the tendency to acquire new cytogenetic abnormalities particularly transformation to extramedullary disease during its blastic phase. These events may be associated with NHL in the setting of blast crisis. Our case report adds to the growing literature on the coexistence of two separate hematological malignancies in a single patient.