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Zhang J, Mu S, Cai L, Ai L, Wu Y. Osteolytic lesions as a presenting sign of acute myeloid leukemia: a case report. Front Oncol 2024; 14:1364266. [PMID: 38751817 PMCID: PMC11094210 DOI: 10.3389/fonc.2024.1364266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/05/2024] [Indexed: 05/18/2024] Open
Abstract
Osteolytic lesions are infrequently observed in adult patients with acute myeloid leukemia (AML). This report details the case of a 66-year-old male patient who presented with myeloid sarcoma (MS), osteolytic lesion and pancytopenia. Effective treatments were delayed due to diagnostic challenges and the rapid progression of the disease. It is essential to consider AML in the differential diagnosis when faced with a patient presenting osteolytic lesions and pancytopenia.
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Affiliation(s)
- Jingqian Zhang
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Lab of Molecular Biological Targeted Therapies of the Ministry of Education, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shidai Mu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Cai
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lisha Ai
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yaohui Wu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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2
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Fatima P, Czerwinski V, Panthi S, Choudhary C. An Unusual Case of Hypercalcemia Due to Graft-Versus-Host Disease. AACE Clin Case Rep 2024; 10:45-48. [PMID: 38523852 PMCID: PMC10958635 DOI: 10.1016/j.aace.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 03/26/2024] Open
Abstract
Background/Objective Hypercalcemia is a common disorder with a wide differential and is most commonly related to malignancy and hyperparathyroidism. Hypercalcemia is a rarely reported consequence of graft-versus-host disease (GVHD) and may be related to a granulomatous manifestation of the common stem cell transplantation procedure. Case Report A 67-year-old woman with a history of allogenic stem cell transplantation due to myelodysplastic syndrome presented to the bone marrow transplant clinic with dysphagia, muscle aches, and rash. She was found to have an extremely increased calcium and 1,25-dihydroxyvitamin D levels, which were ultimately corrected with administration of steroids and zoledronic acid. Discussion While uncommon, granulomatous disease can lead to hypercalcemia via the activation of 1α-hydroxylase within macrophages, which, in turn, activates 1,25-dihydroxyvitamin D leading to an increased serum calcium level. GVHD is a common, variably presenting complication of bone marrow transplantation. Granulomatous processes related to GVHD may mediate hypercalcemia in patients with both increased calcium and 1,25-dihydroxyvitamin D levels. Conclusion This is a rare cause of calcitriol-mediated hypercalcemia associated with GVHD. There have been cases of granulomas associated with GVHD, and this could potentially lead to ectopic production of calcitriol. We deemed GVHD to be a likely cause of the patient's calcitriol-mediated hypercalcemia because we did not find another etiology that fit the clinical findings. Physician awareness of this complication and the appropriate workup will allow future researchers to properly elucidate the etiology of this rare complication.
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Affiliation(s)
- Paras Fatima
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | | | - Sujata Panthi
- Department Endocrinology, University of Indiana Medical Center, Indianapolis, Indiana
| | - Chitra Choudhary
- Division of Endocrinology, Metabolism and Clinical Pharmacology, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
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Okazaki S. De Novo Pure Erythroid Leukemia With Rapid Progression and Multiple Lytic Bone Lesions: A Case Report. Cureus 2023; 15:e41581. [PMID: 37559863 PMCID: PMC10406580 DOI: 10.7759/cureus.41581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2023] [Indexed: 08/11/2023] Open
Abstract
A 62-year-old male patient presented with malaise and severe macrocytic anemia. Computed tomography revealed an osteolytic lesion in the left iliac bone. Bone marrow examination revealed that 90% of erythroblasts were large with periodic acid-Schiff (PAS)-positive staining while flow cytometry and immunostaining revealed CD71 (+), GP-A (+), p53 (+), CD117 (+), and CD34 (-) results, indicating pure erythroid leukemia (PEL) diagnosis. A needle biopsy of the osteolytic lesion revealed the same characteristics as PEL. Azacitidine therapy was administered as the first-line treatment, and his general condition temporarily improved. However, PEL quickly deteriorated, and he died 42 days of hospitalization after initial admission. PEL is an extremely rare form of acute myeloid leukemia (AML) and has presented cytogenetic characteristics in addition to the TP53 mutation. Other AML treatment is used because a standard treatment method is unavailable. However, the prognosis is extremely poor. Furthermore, few cases of concurrent bone lesions are reported globally, and more cases must be accumulated and analyzed.
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An interesting case of bisphosphonate resistant hypercalcemia in acute myelogenous leukemia (AML). JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY CASE REPORTS 2022. [DOI: 10.1016/j.jecr.2022.100126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Patel S, Bledsoe J, Gordon J, Cerny J. Extramedullary Acute Myeloid Leukemia of the Renal Pelvis: Insights into a Visceral Niche. Acta Haematol 2020; 144:297-301. [PMID: 32814320 DOI: 10.1159/000508526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/07/2020] [Indexed: 11/19/2022]
Abstract
Acute myeloid leukemia (AML) is a stem cell malignancy that originates in the bone marrow and involves the peripheral blood. Extramedullary AML is rarer, but it is most commonly associated with the former French-American-British (FAB) subtypes M4 or M5 of AML. AML cells may also home to the central nervous system and other solid organs such as cortical bone and skin. Such target sites of metastasis depend on microenvironmental niche interactions, which have not been fully elucidated to date. Visceral organs usually do not represent a favorable niche for AML stem cell occupancy. Herein, we describe the case of an 80-year-old man with extramedullary AML involvement of the renal pelvis. Hypercalcemia and obstructive uropathy were presenting features. The visceral niche is a rare site of involvement of myeloid malignancy, and hypercalcemia may reflect a mechanism of extramedullary involvement. We propose a treatment paradigm for this uncommon subset of AML based on advanced age and complex karyotype.
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Olatunji PO, Ojo OT, Bello FO, Bakare BY, Olatunji AO. A case of acute megakaryoblastic leukaemia (FAB M7), a rare type of acute myeloid leukemia (AML), in a teenager. Malawi Med J 2019; 30:298-301. [PMID: 31798811 PMCID: PMC6863413 DOI: 10.4314/mmj.v30i4.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Acute Megakaryoblastic Leukaemia (AML, M7) is a rare type of acute myeloid leukemia (AML) evolving from primitive megakaryoblasts. It accounted for 1.2% of newly diagnosed AML according to Eastern Cooperative Oncology Group (ECOG) trials between 1984 and 1997. Patients may present with a broad variety of symptoms including low-grade fever, easy bruising, and life-threatening conditions. We report a rare case of AML, M7 in a 19-year-old lady who presented with weakness and fatigue. She was diagnosed as a case of AML, M7 on the basis of peripheral blood finding, bone marrow examination report, radiological findings and immunophenotyping.
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Affiliation(s)
- Philip O Olatunji
- Department of Haematology and Blood Transfusion, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
| | - Omotola T Ojo
- Department of Haematology and Blood Transfusion, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
| | - Fatai O Bello
- Department of Haematology and Blood Transfusion, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
| | - Binta Y Bakare
- Department of Haematology and Blood Transfusion, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
| | - Ayodeji O Olatunji
- Department of Radiology, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
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Guillaume D, Hélène M, Béatrice B. Singular case of osteolytic lesions revealing transformation of myeloproliferative syndrome to acute leukemia. Joint Bone Spine 2018; 86:251-253. [PMID: 30471421 DOI: 10.1016/j.jbspin.2018.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2018] [Indexed: 11/26/2022]
Abstract
Hematological malignancies can cause bone lesions, of which the most common are the punched-out foci of osteolysis seen in multiple myeloma. However, osteosclerotic lesions are more common in myeloproliferative disorders. We report the unusual case of a patient with myeloproliferative syndrome in whom the development of osteolytic lesions revealed transformation to acute leukemia. In 2007, this 82-year-old man with essential thrombocythemia since 1994 developed primary polycythemia with the JAK2 mutation V617F. In July 2017, he was evaluated for an osteolytic lesion in the right humerus with incipient fracturing. Bone marrow smear results provided only limited information, due to the myelofibrosis, showing 7% of blast cells with no plasmacytosis. No solid malignancies were identified by imaging studies. Examination of a right humeral biopsy specimen taken during internal fixation showed myeloproliferative syndrome with osteosclerosis and grade-3 myelofibrosis, as well as a malignant proliferation of large cells carrying the leukocyte cluster of differentiation antigens CD45, CD 43, CD4, and CD34. The diagnosis was transformation of the myeloproliferative syndrome to acute myeloid leukemia. The development of an osteolytic lesion during the course of myeloproliferative syndrome is an exceedingly rare event that should suggest acute leukemic transformation.
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Affiliation(s)
- Duval Guillaume
- Service de gériatrie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | - Meytadier Hélène
- Service de gériatrie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | - Bouvard Béatrice
- Service de rhumatologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France; Groupe d'Eudes Remodelage Osseux et bioMatériaux LHEA UPRES EA 4658, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France.
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Chang TY, Jaing TH, Chen SH. Treatment of critical hypercalcemia using pamidronate in acute megakaryoblastic leukemia in an 18-month-old girl. Pediatr Neonatol 2017; 58:462-464. [PMID: 28427853 DOI: 10.1016/j.pedneo.2016.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 08/22/2016] [Accepted: 09/12/2016] [Indexed: 11/25/2022] Open
Affiliation(s)
- Tsung-Yen Chang
- Division of Hematology/Oncology, Department of Pediatrics, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
| | - Tang-Her Jaing
- Division of Hematology/Oncology, Department of Pediatrics, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Shih-Hsiang Chen
- Division of Hematology/Oncology, Department of Pediatrics, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
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Application of Immunohistochemistry in Toxicologic Pathology of the Hematolymphoid System. IMMUNOPATHOLOGY IN TOXICOLOGY AND DRUG DEVELOPMENT 2017. [DOI: 10.1007/978-3-319-47377-2_10] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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10
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Osteolytic Bone Lesions - A Rare Presentation of AML M6. Mediterr J Hematol Infect Dis 2015; 7:e2015017. [PMID: 25745544 PMCID: PMC4344168 DOI: 10.4084/mjhid.2015.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 01/02/2015] [Indexed: 11/08/2022] Open
Abstract
Acute myeloid leukemia (AML) M6 is a rare form of AML accounting for < 5 % of all AML. Extramedullary involvement is very rarely seen in this entity. Skeletal lesion has not been described in AML M6 before. We discuss the case of a 17 year old boy with AML M6, who presented with osteolytic lesion of right humerus. He was treated with induction and consolidation chemotherapy. The present case is the first report in literature of AML M6 presenting with skeletal lesions.
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11
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Secondary Leukemia After Chemotherapy and/or Radiotherapy for Gynecologic Neoplasia. Int J Gynecol Cancer 2014; 24:178-83. [DOI: 10.1097/igc.0000000000000045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ObjectiveSecondary leukemia is a known complication of chemotherapy and radiotherapy. It was generally recognized that leukemia secondary to chemotherapy was due to the use of alkylating agents in the treatment of ovarian cancer. Recently, many types of chemotherapeutic agents have been used in the treatment of gynecologic malignancies in addition to ovarian cancer. We analyzed the clinical characteristics and outcome of patients with recent onset of secondary leukemia after the treatment of gynecologic cancer to consider the diagnosis and management of secondary leukemia.Materials and MethodsWe reviewed the clinical charts and follow-up data of patients with gynecologic malignancies treated in the past 20 years. During this period, 2482 newly diagnosed invasive gynecologic cancers were treated in our institution. All patients with secondary leukemia were analyzed for clinical background, latency period (interval between the diagnosis of primary carcinoma and the development of leukemia), treatment, and outcome. We also reviewed the literature for secondary leukemia under gynecology using the PubMed.ResultsFour patients were found to have developed secondary leukemia after the treatment of gynecologic malignancies during this period. The cumulative risk of secondary leukemia was approximately 0.38%. All patients received platinum-based chemotherapy. Two patients received combination chemotherapy and/or bone marrow transplantation, and 1 of these 2 patients lived more than 6 years but died of recurrent ovarian cancer.ConclusionsLong survival time might be expected in patients who show complete response to bone marrow transplantation and/or combination chemotherapy for secondary leukemia. In recent years, we have aggressively used various types of anticancer drugs for the treatment of not only ovarian cancer but also uterine cervical cancer and endometrial cancer. Physicians need to keep in mind the risk of secondary leukemia in the follow-up of long-term survivors after several courses of chemotherapy and radiotherapy.
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A rare case of adult acute lymphoblastic leukemia presenting with paraparesis and multiple osteolytic lesions. Indian J Hematol Blood Transfus 2013; 30:24-6. [PMID: 25332525 DOI: 10.1007/s12288-012-0221-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Accepted: 12/12/2012] [Indexed: 11/27/2022] Open
Abstract
Acute lymphoblastic leukemia presenting with bone involvement and multiple osteolytic lesions has been commonly reported in pediatric population. Various myeloid and lymphoid malignancies can rarely present with bony lesions. We are reporting an adult female patient with acute lymphoblastic leukemia who presented with paraparesis and multiple osteolytic lesions in skull initially giving false impression of multiple myeloma.
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13
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Rehg JE, Bush D, Ward JM. The utility of immunohistochemistry for the identification of hematopoietic and lymphoid cells in normal tissues and interpretation of proliferative and inflammatory lesions of mice and rats. Toxicol Pathol 2012; 40:345-74. [PMID: 22434870 DOI: 10.1177/0192623311430695] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Expression of antigens in cells and tissues can be readily studied immunohistochemically with the use of antibodies. A panel of antibodies to cell-specific markers can be used to diagnose lesions, including tumors, in the hematopoietic and lymphoid systems. This review discusses the use of readily available antibodies and procedures to identify antigens expressed in normal tissues and in proliferative and inflammatory lesions in formalin-fixed, paraffin-embedded (FFPE) murine specimens.
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Affiliation(s)
- Jerold E Rehg
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee 38105, USA.
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14
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Giannakoulas NC, Terpos E, Palassopoulou M, Zolota V, Lampropoulou P, Symeonidis A, Matsouka P. Increased RANKL and IL-6 levels might result in high bone turnover in a case of a CD34+/CD117+/myeloperoxidase(+dim) acute myeloid leukemia presenting with severe hypercalcemia and lumbar spine fractures. Leuk Res 2011; 35:e188-9. [PMID: 21802729 DOI: 10.1016/j.leukres.2011.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 06/14/2011] [Accepted: 07/04/2011] [Indexed: 10/17/2022]
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Malieckal D, Jhaveri KD, Chawla A. Invited Manuscript Poster on Renal-Related Education American Society of Nephrology, Nov. 16–21, 2010 Nephrology Teaching Tool: Anagrams. Ren Fail 2011; 33:736-40. [DOI: 10.3109/0886022x.2011.589938] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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An instructive case of hypercalcemia preceding relapse of AML following allogeneic BMT. Bone Marrow Transplant 2010; 46:1028-9. [PMID: 20921940 DOI: 10.1038/bmt.2010.228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Sargent JTS, Smith OP. Haematological emergencies managing hypercalcaemia in adults and children with haematological disorders. Br J Haematol 2010; 149:465-77. [PMID: 20377591 DOI: 10.1111/j.1365-2141.2010.08173.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Hypercalcaemia is a common metabolic complication of malignant disease often requiring emergency intervention. Although it is more frequently associated with solid tumours, malignancy-associated hypercalcaemia (MAH) is seen in a significant number of patients with blood diseases. Its association with myeloma and adult T-cell leukaemia/lymphoma is well recognized but the incidence of hypercalcaemia in other haematological neoplasms, affecting adults and children, is less clearly defined. Haematologists need to be familiar with the clinical manifestations of, the differential diagnosis to be considered and the most effective management strategies that are currently available for MAH. The key components of management of MAH include aggressive rehydration, specific therapy to inhibit bone resorption and, crucially, treatment of the underlying malignancy. Bisphosphonates have revolutionized the management of MAH over the last 20 years, however the elucidation of molecular pathways implicated in MAH is facilitating the development of more targeted approaches to treatment.
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Affiliation(s)
- Jeremy T S Sargent
- Trinity College, and Department of Haematology & Oncology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
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Hypercalcemia in pediatric acute megakaryocytic leukemia: case report and review of the literature. J Pediatr Hematol Oncol 2009; 31:373-6. [PMID: 19415024 DOI: 10.1097/mph.0b013e31819a5d29] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Hypercalcemia has been described as a possible complication of many pediatric malignancies. Here, we report an 8-month-old non-Down syndrome infant with acute megakaryocytic leukemia and severe hypercalcemia at presentation. A review of the literature reveals that this is the first case of hypercalcemia complicating acute megakaryocytic leukemia reported in the pediatric literature. His initial workup, and the course of management and outcome, is described in detail. Though the etiology of this complication remains unclear, our experience suggests that early institution of chemotherapy along with supportive care is the best treatment for control of hypercalcemia.
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Alioglu B, Tuncay IC, Ozyurek E, Avci Z, Ozbek N. Bone fracture: an unusual presentation of acute megakaryoblastic leukemia. Pediatr Hematol Oncol 2009; 26:62-9. [PMID: 19206010 DOI: 10.1080/08880010802434818] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Some clinical manifestations of acute leukemia in children can mimic orthopedic conditions, and t is variable presentation often makes diagnosis difficult. Bone changes in leukemia are well documented, but there are only a few accounts of children with acute leukemia who present with bone fractures. This report describes a case of this rare combination in a very young boy who presented with fractures of both proximal humerus and left proximal femur and massive periosteal reactions of both humerus and femur and also cystic lesions of proximal femur and iliac bone accompanying aggressive acute megakaryoblastic leukemia.
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Affiliation(s)
- Bulent Alioglu
- Baskent University Faculty of Medicine, Department of Pediatric Hematology, Ankara, Turkey.
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Yeasmin S, Nakayama K, Ishibashi M, Oride A, Katagiri A, Purwana IN, Iida K, Nakayama N, Ishikura H, Miyazaki K. Therapy-related myelodysplasia and acute myeloid leukemia following paclitaxel- and carboplatin-based chemotherapy in an ovarian cancer patient: a case report and literature review. Int J Gynecol Cancer 2008; 18:1371-6. [PMID: 18217963 DOI: 10.1111/j.1525-1438.2007.01185.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Alkylating agents have strong leukemogenic potential. There are a number of recent acute myeloid leukemia (t-AML) cases related to previous paclitaxel exposure. These leukemias tend to be of aggressive subtypes with long-latency periods. Unlike previously reported cases, the present case was of the secondary acute megakaryoblastic myeloid leukemia (AML M7) subtype. Additionally, it did not harbor a translocation in chromosome 19. A 73-year-old woman was diagnosed with t-AML M7 with antecedent myelodysplasia. Leukemia followed a second induction of paclitaxel- and carboplatin-based chemotherapy for recurrent ovarian cancer. Her second induction began 25 months after completion of her first course of chemotherapy. The increased incidence of postpaclitaxel leukemia suggests a probable role for paclitaxel as a leukemogenic agent. It highlights the importance of assessing for leukemia risk factors prior to beginning paclitaxel therapy.
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Affiliation(s)
- S Yeasmin
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo, Shimane, Japan
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Kounami S, Yoshiyama M, Nakayama K, Hiramatsu C, Aoyagi N, Yoshikawa N. Severe hypercalcemia in a child with acute nonlymphocytic leukemia: the role of parathyroid hormone-related protein and proinflammatory cytokines. Acta Haematol 2004; 112:160-3. [PMID: 15345899 DOI: 10.1159/000079728] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2003] [Accepted: 12/22/2003] [Indexed: 01/06/2023]
Abstract
Among the hematological malignancies, hypercalcemia has often been reported in lymphoid malignancies such as multiple myeloma and adult T cell leukemia/lymphoma, but it has only rarely been described in acute nonlymphocytic leukemia. We describe here a 14-month-old girl with acute monocytic leukemia complicated by severe hypercalcemia (4.6 mmol/l) at presentation. A bone survey showed generalized bone resorption, but no localized osteolytic lesions. A search for the etiology of the hypercalcemia revealed that the serum levels of parathyroid hormone-related protein (PTHrP) and also proinflammatory cytokines with stimulatory effects on osteolytic bone resorption - TNF-alpha, IL-6 and M-CSF - were elevated. The patient achieved complete remission with induction chemotherapy, and the levels of PTHrP and the cytokines became normalized. In this case, PTHrP and cytokines might have acted cooperatively to exacerbate bone resorption, resulting in severe hypercalcemia.
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Affiliation(s)
- Shinji Kounami
- Department of Pediatrics, Wakayama Medical University, Wakayama City, Japan.
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Johnson JL, Moscinski L, Zuckerman K. Value of Positron Emission Tomography Scan in Staging Cancers, and an Unusual Presentation of Acute Myeloid Leukemia. J Clin Oncol 2004; 22:2968-70. [PMID: 15254066 DOI: 10.1200/jco.2004.09.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jennifer L Johnson
- H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL, USA
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