Treatment of long-lasting priapism in chronic myeloid leukemia at onset

Priapism is a rare complication of chronic myeloid leukemia (CML). observed in 1-2% of males [5]. Its occurrence is always related to a high white blood cell (WBC) count that induces formation of microaggregates, causing sludging in veins with blood stasis and reduced venous efflux from the corpora cavernosa. The most common long-term sequela is a massive thrombosis of the corpora cavernosa with irreversible fibrosis and functional impotence. Many different approaches, such as cytotoxic drugs, cell depletion by leukapheresis, spinal irradiation, anti coagulants, fibrinolysins, multiple punctures of the corpora cavernosa, or surgical intervention of cavernospongiosum shunt, have been used to promptly resolve this complication in order to avoid the functional defect [1-4]. However, at present, there is no agreement on the best therapeutic management of this rare complication.