Chronic myeloid leukemia following low dose radioactive iodine (I131) for treatment of papillary thyroid cancer

Introduction: Therapy-related myeloid neoplasms result from exposure to specific agents such as ionizing radiation, chemotherapy, and immunosuppressive agents. Radioactive iodine plays an essential role in managing differentiated thyroid cancers such as papillary thyroid carcinoma to reduce the risk of recurrence. Patient concerns: We present the case of a 48-year-old Bangladeshi male with a history of papillary thyroid cancer after total thyroidectomy and radiofrequency ablation therapy with I131 (32.6 mCi) who presented with abdominal pain and was found to have chronic myeloid leukemia 3 years after treatment for papillary thyroid cancer. Diagnosis: Chronic myeloid leukemia secondary to low-dose radioactive iodine (I131). Interventions: The patient was started on dasatinib (140 mg/day). Outcomes: The patient is currently being prepared for bone marrow transplantation by donor search and HLA typing. Conclusion: This case emphasizes the importance of considering the leukemogenic effects of I131.