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Chronic myelogenous leukemia complicated by hypofibrinogenemia.

To the Editor.— Disseminated intravascular coagulation with hypofibrinogenemia is an unusual complication of acute leukemia, especially acute promyelocytic leukemia. 1 However, hypofibrinogenemic bleeding as a complication of chronic myelogenous leukemia (CML) must be a rare event, since this has been reported only once previously. 2 We report an additional case of CML in which hypofibrinogenemia appears to have played a major role in the patient's death. Report of a Case.— A 57-year-old man was admitted to the Philadelphia Veterans Administration Hospital complaining of three days of nausea and vomiting, weakness, malaise, and an exacerbation of a previously troublesome frontal headache. He had known CML (Philadelphia chromosome positive) for three years, during which he manifested sharp fluctuations in his peripheral WBC counts (20,000/cu mm to 150,000/cu mm) in the absence of chemotherapy. On admission his medications included allopurinol and hydrochlorothiazide. Physical examination showed an ill-appearing man. His blood pressure was 170/90