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

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 fecalprotoporphyrin 22-38 µg./Gm. dry weight. A review of the clinical aspects ofporphyria is briefly presented, together with some speculation as to the etiologyof the porphyria in the present case. The possibility is present that the busulfantherapy either initiated the disorder or triggered its development from a previously occult state. If so, this would be another manifestation of busulfantoxicity, of which pigmentation is the most common.

Submitted on September 13, 1963 Accepted on November 17, 1963