CML blast crisis resulting in biliary obstruction following BMT

Allogeneic BMT is the treatment of choice for various hematologic malignancies, Despite careful patient scrutiny, a large number of patients experience significant morbidity and mortality due to procedure-related toxicity, Hepatobiliary toxicity presenting as biliary cholestasis, due to the preparative regimen (ie venoocclusive disease), supportive pharmaceuticals, and/or GVHD have been implicated, We report a unique cause of cholestasis in a patient undergoing BMT for CML, The cholestasis was found to be secondary to relapsed leukemia, which resulted in a granulocytic sarcoma obstructing the biliary ductal system.