{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T06:03:27Z","timestamp":1784527407390,"version":"3.55.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>Chronic myeloid leukemia (CML) is a rare hematologic malignancy in children, typically presenting with leukocytosis in the peripheral blood, and often accompanied by symptoms such as fever or splenomegaly. This report describes a rare pediatric case of CML that manifested solely as isolated thrombocytosis. Due to this atypical presentation, the patient was initially misdiagnosed with essential thrombocythemia (ET) and treated with hydroxyurea and aspirin, which yielded no clinical response. The diagnosis of CML was subsequently confirmed by detection of the BCR::ABL1 fusion gene. Upon confirmation, the patient was promptly initiated on imatinib therapy and achieved a complete cytogenetic response within 4 months. We also conducted a literature review of similar cases, discussing their prognosis and differential diagnosis with ET, and recommend early BCR::ABL1 fusion gene testing in all pediatric patients presenting with isolated thrombocytosis to ensure accurate diagnosis.<\/jats:p>","DOI":"10.3389\/fped.2026.1846571","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T05:33:53Z","timestamp":1784525633000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Chronic myeloid leukemia masquerading as essential thrombocythemia in a child: the imperative for early BCR::ABL1 testing in isolated thrombocytosis"],"prefix":"10.3389","volume":"14","author":[{"given":"Haoping","family":"He","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Qilu Hospital of Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinqiu","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Qilu Hospital of Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1618","DOI":"10.1001\/jama.2025.0220","article-title":"Chronic myeloid leukemia: a review","volume":"333","author":"Jabbour","year":"2025","journal-title":"JAMA"},{"key":"B2","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1182\/blood-2015-06-648667","article-title":"Pediatric chronic myeloid leukemia is a unique disease that requires a different approach","volume":"127","author":"Hijiya","year":"2016","journal-title":"Blood"},{"key":"B3","doi-asserted-by":"publisher","first-page":"900","DOI":"10.21147\/j.issn.1000-9604.2025.06.03","article-title":"Leukemia epidemiology in China: burden, trends, and determinants in the 21st century","volume":"37","author":"Hu","year":"2025","journal-title":"Chin J Cancer Res"},{"key":"B4","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1007\/s11912-021-01025-x","article-title":"Chronic myelogenous leukemia in childhood","volume":"23","author":"Smith","year":"2021","journal-title":"Curr Oncol Rep"},{"key":"B5","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1542\/peds.2004-2473","article-title":"Clinical and biological features at diagnosis in 40 children with chronic myeloid leukemia","volume":"116","author":"Millot","year":"2005","journal-title":"Pediatrics"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1280","DOI":"10.3324\/haematol.2025.288283","article-title":"Children with chronic phase chronic myeloid leukemia: characteristics and outcomes from the international registry of childhood CML","volume":"111","author":"Millot","year":"2025","journal-title":"Haematologica"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2374","DOI":"10.1182\/blood.2018882233","article-title":"How I treat chronic myeloid leukemia in children and adolescents","volume":"133","author":"Hijiya","year":"2019","journal-title":"Blood"},{"key":"B8","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1007\/s11912-024-01502-z","article-title":"BCR\/ABL-Positive chronic myeloid leukemia in children: current treatment approach","volume":"26","author":"Menger","year":"2024","journal-title":"Curr Oncol Rep"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e170","DOI":"10.1093\/labmed\/lmad053","article-title":"Is very high platelet count always associated with essential thrombocythemia? 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