A case of simultaneous occurrence of acute myeloid leukemia and multiple myeloma

Simultaneous occurrence of multiple myeloma and acute myeloid leukemia: Case report and literature review

Multiple myeloma (MM) and acute myeloid leukemia (AML) are malignant clonal diseases of cells in different lineages. It remains very rare to have both diseases at first diagnosis. Only 24 cases of this situation were reported from 1971 to 2021, and poor prognosis in most cases. However, here we describe a case of de novo MM and AML occurring simultaneously in a 65-year-old woman. We have successfully used individualized treatment regimens to allow the patient to survive 1.5 years to date, which has exceeded 80 % of statistical cases.

Hema-seq reveals genomic aberrations in a rare simultaneous occurrence of hematological malignancies

Co-occurrence of multiple myeloma and acute myelogenous leukemia is rare, with both malignancies often tracing back to multipotent hematopoietic stem cells. Cytogenetic techniques are the established baseline for diagnosis and characterization of complex hematological malignancies. In this study, we develop a workflow called Hema-seq to delineate clonal changes across various hematopoietic lineages through the integration of whole-genome sequencing, copy-number variations, cell morphology, and cytogenetic aberrations. In Hema-seq, cells are selected from Wright-stained slides and fluorescent probe-stained slides for sequencing. This technique therefore enables direct linking of whole-genome sequences to cytogenetic profiles. Through this method, we mapped sequential clonal alterations within the hematopoietic lineage, identifying critical shifts leading to myeloma and acute myeloid leukemia (AML) cell formations. By synthesizing data from each cell lineage, we provided insights into the hematopoietic tree's clonal evolution. Overall, this study highlights Hema-seq's capability in deciphering genomic heterogeneity in complex hematological malignancies, which can enable better diagnosis and treatment strategies.

Twin Malignancy of Acute Myeloid Leukemia and Multiple Myeloma in a Chemotherapy-Naïve Patient: A Rare Occurrence

Synchronous diagnosis of acute myeloid leukemia (AML) and multiple myeloma in chemotherapy-naïve patients is a rare event and poses a serious therapeutic challenge as it imparts a poor prognosis. We report a case of concurrent AML with multiple myeloma in a 44-year-old male along with a PUBMED-based research of previously reported similar cases in published literature.

Double trouble: A case of synchronous presentation of acute myeloid leukaemia and multiple myeloma

Malignancies following successful chemotherapy for various malignant diseases, including multiple myeloma (MM), are well known and documented. The occurrence of acute myeloid leukaemia (AML) after chemotherapy for MM with alkylating agents is well described; however, simultaneous occurrence of the two entities with no prior therapy is extremely rare. We describe a case of an elderly patient with no previous exposure to chemotherapy, who was diagnosed with both MM and AML concurrently. Very few similar cases have been described in the literature.

Synchronous detection of multiple myeloma and acute myeloid leukemia: A diagnostic and therapeutic challenge

INTRODUCTION

Synchronous detection of multiple myeloma and acute myeloid leukemia in a single patient is a rare coincidence. Treatment of these patients is still unclear, mostly based on acute myeloid leukemia strategies combined with bortezomib.

CASE REPORT

A 72-year-old male with no medical history was investigated for pancytopenia. On medical examination, he was complicated with a wide and severe skin infection on arm. On examination of bone marrow aspirate, 25% myeloblasts infiltration and additional 10% plasma cells were seen. Acute myeloid leukemia was diagnosed and plasma cell proliferation was attributed to reactive plasmacytosis due to skin infection. However, flowcytometric studies and immunohistochemical examination revealed two different cell populations with 30-40% atypical plasma cells and >20% myeloblasts. Serum M-protein detected by serum electrophoresis test and immunofixation test revealed a monoclonal IgG lambda band. He was diagnosed with concurrent acute myeloid leukemia and multiple myeloma without history of chemotherapy.Management and outcome: The patient was initially treated with bortezomib and dexamethasone for the myeloma. Subsequently, azacitidine was administered subcutaneously for the acute myeloid leukemia treatment. The tru-cut biopsy of the lesion on his arm revealed suppurative inflammatory findings and no malign cells detected. Antibiotherapy was started according to susceptibility. He expired after three months of survival.

DISCUSSION

The synchronous occurrence of these two different clonal hematological malignancies is rare in hematology practice. Patient-based prospective studies and case series are needed to guide diagnosis and treatment strategies. Furthermore, this report highlights the importance of ruling out reactive plasmacytosis in patients with hematological malignancy who developed severe infections.

Acute myeloid leukemia synchronous with multiple myeloma successfully treated by azacytidine/lenalidomide and daratumumab without a decrease in myeloid clone size

Synchronous diagnosis of acute myeloid leukemia (AML) and symptomatic multiple myeloma (MM) is a rare situation that poses serious therapeutic difficulties. We report the case of a 68-year-old male which evolved simultaneously to symptomatic MM and AML. Both diseases first responded to treatment for 40 months after 7+3 induction and maintenance therapy of azacytidine + lenalidomide. MM relapsed first and was treated with azacytidine + daratumumab, which led an additional 15 months of progression-free survival. Little myeloid clonal size reduction over time was seen. This case shows that AML and MM can be effectively treated simultaneously using appropriate combinations.