Chronic myeloid leukaemia and a myasthenic syndrome

This is the first report of a case of chronic myeloid leukaemia (CML) complicated by myasthenic syndrome. The patient suffered two prolonged periods of idiosyncratic busulphan-induced marrow aplasia, the first occurring 5 months after busulphan was stopped. Between these two episodes, and at a time when no therapy was required for the leukaemia, myasthenic syndrome developed. After the patient recovered from the second episode, the myasthenic syndrome disappeared, and, despite subsequent recrudescence of CML, there were no further myasthenic symptoms, and treatment with neostigmine was discontinued.