Coexistence of Chronic Myeloid Leukemia and Hodgkin’s Lymphoma: A Case Report at the National Hospital of Niamey (Niger)

Introduction: The coexistence of chronic myeloid leukemia and Hodgkin lymphoma (HL) is rare. In the few reported cases, HL occurs after a varying duration of treatment with tyrosine kinase inhibitors (TKIs). However, in our patient, the diagnosis of these two diseases was simultaneous. Observation: This is a 38-year-old female patient with no known medical history, hospitalized for vomiting and low back pain in a febrile context. There was a deterioration in WHO 3 general condition and generalized pruritus. Stage III splenomegaly and diffuse axillary, inguinal, laterocervical, and bilateral submaxillary adenopathies, non-symmetrical, were observed. Hepatomegaly, pulmonary consolidation syndrome, and generalized skin lesions were also noted. The blood count showed hyperleukocytosis at 22,339/mm³ with neutrophil predominance at 19,500/mm³. The blood smear revealed immature myelemia. The BCR-ABL transcript search was positive. The karyotype was not carried out due to the lack of resources. The lymph node biopsy and histology performed concluded that there was classic sclero-nodular HL and the immunohistochemistry performed confirmed the diagnosis. The patient received treatment with first-generation TKIs. Treatment was initiated 24 hours after diagnosis, at a dose of 400 mg per day and six (6) cycles of chemotherapy using the ABVD protocol, including two weeks between two cycles. The evolution was marked by the death of the patient despite a good clinical course, in a picture of septic shock following a superinfection of her skin lesions. Conclusion: The coexistence of CML with Hodgkin lymphoma is a poor prognostic condition. Despite its rarity, it should be considered in the presence of adenopathic polymorphism in chronic myeloid leukemia.