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Priapism complicating chronic granulocytic leukemia
Insights
Priapism can be an early indicator of chronic granulocytic leukemia (CGL). Prompt reduction of high leukocyte counts in CGL patients presenting with priapism is crucial for effective management.
Area of Science:
- Hematology
- Oncology
- Urology
Background:
- Priapism, a prolonged erection, can be a rare presenting symptom of hematologic malignancies.
- Chronic granulocytic leukemia (CGL) is a myeloproliferative neoplasm characterized by elevated white blood cell counts.
Purpose of the Study:
- To investigate the association between priapism and chronic granulocytic leukemia (CGL).
- To evaluate the incidence and management outcomes of priapism in CGL patients.
Main Methods:
- Retrospective review of ten male patients diagnosed with CGL who presented with priapism.
- Analysis of patient histories, leukocyte counts, and treatment modalities.
Main Results:
- Ten male patients with CGL presented with priapism, with an estimated incidence of 1%-2% among male CGL patients.
- All patients exhibited significantly elevated leukocyte counts (mean 380 X 10(9)/liter).
- Prompt reduction of leukocyte counts appeared more beneficial than surgical interventions.
Conclusions:
- Priapism is a potential, albeit rare, presenting sign of CGL.
- Effective management of CGL-associated priapism involves prompt reduction of leukocyte count.
Abstract:
Since 1952 we have seen nine patients with priapism leading to a diagnosis of chronic granulocytic leukemia (CGL) and a tenth patient who gave a history of priapism when CGL was diagnosed as a result of other symptoms. Seven patients had had one or more transient episodes of prolonged erection before the diagnosis of CGL was established. All ten had high blood leukocyte counts (mean 380 X 10(9)/liter, range 186-782) in comparison with other newly diagnosed patients. We estimate the incidence of this complication at 1%-2% of all male patients presenting with CGL. Treatment of patients in this series varied greatly. Five patients were treated mainly by local measures with r without cytotoxic drugs at conventional dosage, three were treated by sapheno-cavernous bypass operations and leukapheresis followed by cytotoxic drugs at high dosage, and two were treated initially by leukapheresis alone. In general, the prompt initiation of measures designed to reduce the leukocyte count seemed more valuable than the surgical procedures employed in these patients.