Prolonged imatinib-induced myelosuppression in chronic myeloid leukaemia with an unusually long survival.

A case of Philadelphia chromosome positive chronic myeloid leukaemia (CML) with the longest survival ever reported in the medical literature is presented. The duration of the chronic phase was 29 years, the overall survival being 31 years. The clinical course, when challenged with imatinib in the later stages of the disease, was at variance with what is to be expected from the experience in similar situations. Lifelong myelosuppression resulted that interfered with further therapy and contributed to the demise of the patient from sepsis three years later. Caution is suggested with the use of imatinib in fibrotic CML with a low platelet count.