Porphyria Cutanea Tarda Associated with Chronic Granulocytic Leukemia Treated with Busulfan (Myleran)

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Abstract
A patient with chronic granulocytic leukemia terminating in "blast crisis" and marked porphyria is presented. Quantitative porphyrin studies revealed: urinary uroporphyrin 8894 to 11,453 µg./24 hours, urinary coproporphyrin 107-486 µg./24 hours, fecal coproporphyrin 55-116 µg./Gm. dry weight and fecal protoporphyrin 22-38 µg./Gm. dry weight. A review of the clinical aspects of porphyria is briefly presented, together with some speculation as to the etiology of the porphyria in the present case. The possibility is present that the busulfan therapy either initiated the disorder or triggered its development from a previously occult state. If so, this would be another manifestation of busulfan toxicity, of which pigmentation is the most common.