Review of Bleeding as Initial Presentation in Patients with Chronic Myeloid Leukemia

/L) and frequent anemia (median hemoglobin 8.5 g/dL; 71% < 10 g/dL), with highly variable platelet counts. Defined acquired bleeding disorders were uncommon. Management was medical/supportive in 47% and surgical or interventional in 36%, particularly for CNS and splenic events. At last follow-up, 62% were alive, 21% had died-mainly from intracranial hemorrhage or splenic rupture-and some survivors had permanent sequelae.ConclusionBleeding as the initial presentation of CML, though rare, carries substantial morbidity and mortality, especially with CNS or splenic involvement. Clinicians should consider CML in unexplained major bleeding with marked leukocytosis. Early diagnosis, prompt CML-directed therapy, and site-specific hemorrhage management are crucial.