scholarly journals Paclitaxel Induced MDS and AML: A Case Report and Literature Review

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Udit Bhaskar Bhatnagar ◽  
Daulath Singh ◽  
Alexy Glazyrin ◽  
Jill Moormeier
Keyword(s):  
Literature Review ◽  
Acute Myelogenous Leukemia ◽  
Case Reports ◽  
Alkylating Agents ◽  
Treatment Options ◽  
Myelogenous Leukemia ◽  
Refractory Anemia ◽  
Myeloid Neoplasm ◽  
Acute Myelogenous ◽  
Acute Myelomonocytic Leukemia

Therapy related acute myelogenous leukemia (AML) and myelodysplastic syndromes (MDS) have been classically linked to alkylating agents and topoisomerase inhibitors. They constitute about 1% of all AMLs. There is less evidence on association of taxanes (paclitaxel and docetaxel) with these myeloid neoplasms. We present a case of paclitaxel therapy related acute myelogenous leukemia after treatment of endometrial cancer with a regimen containing paclitaxel and carboplatin. A 63-year-old female underwent surgery followed by a total of 6 cycles of chemotherapy with carboplatin and paclitaxel. Six months after last cycle of chemotherapy, she was diagnosed with myelodysplastic syndrome with refractory anemia and excess blasts. Six weeks later, she had worsening anemia and thrombocytopenia which prompted a bone marrow biopsy which revealed acute myelomonocytic leukemia. A thorough literature review revealed 12 other case reports where taxanes have been implicated in the development of therapy related myeloid neoplasm. Based on the timeline of events in our patient, paclitaxel is the likely culprit in the pathogenesis of this myeloid neoplasm. This rare but significantly grave adverse effect should be kept in consideration when deciding on treatment options for gynecological malignancies.

scholarly journals Bacillus cereus Typhlitis in a Patient with Acute Myelogenous Leukemia: A Case Report and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
James D. Denham ◽  
Sowmya Nanjappa ◽  
John N. Greene
Keyword(s):  
Bacillus Cereus ◽  
Acute Myelogenous Leukemia ◽  
English Language ◽  
Neutropenic Patient ◽  
Hematologic Malignancy ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Case Series ◽  
Myelogenous Leukemia ◽  
Acute Myelogenous

Bacillus cereus is a Gram-positive rod that is now recognized as a rare cause of frank disease in the neutropenic hematologic malignancy patient. Because this pathogen is rarely isolated in clinical specimens, no large studies exist to guide the management of these acutely ill patients. Individual case reports and case series exist in the literature describing various clinical manifestations of B. cereus in the neutropenic patient including bacteremia/septicemia, pneumonia, meningitis/encephalitis, hepatic abscesses, and gastritis. In this report, we describe a case of typhlitis caused by B. cereus in a 74-year-old female with recently diagnosed acute myelogenous leukemia (AML), and we summarize the available English language literature to draw tentative conclusions regarding the clinical manifestations of this organism.

Clofarabine, Etoposide and Mitoxantrone In the Therapy of Relapsed and Refractory Acute Myelogenous Leukemia

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4353-4353
Author(s):  
W. Christopher Ehmann ◽  
Sulfikar Ibrahim ◽  
Witold Rybka ◽  
David F. Claxton
Keyword(s):  
Acute Myelogenous Leukemia ◽  
Treatment Options ◽  
Single Agent ◽  
Myelogenous Leukemia ◽  
Dose Finding ◽  
High Dose ◽  
Phase 2 ◽  
Patients Âgés ◽  
Treatment Regimens ◽  
Acute Myelogenous

Abstract Abstract 4353 Currrent therapy for acute myelogenous leukemia depends on the activity of cytosine arabinoside (ara-C). The development of regimens without this agent would potentially provide non-crossresistant treatment options for these disorders. Clofarabine, a novel agent showing significant single agent activity in AML, provides a platform for potentially effective treatment independent of ara-C. We treated 10 patients ages 30–67 (median 51) with relapsed or refractory AML with a phase I dose finding protocol employing a three drug combination based on clofarabine. The objectives were to define a maximally tolerated and recommended phase 2 dose and identify early phase 2 activity. Seven patients (70%) were refractory to 1 or 2 treatment regimens immediately prior to enrollment, the other 3 pts (30%) were relapsed following a remission. All patients had relapsed following or were refractory to standard 7+3 chemotherapy and 7/10 had received intermediate or high dose cytarabine within <52 weeks of enrollment. Patients received clofarabine 20mg/m2 (Dose level 1 – DL1 – 4 patients treated) or 25mg/m2 (DL2 – 6 patients) days 2–6, etoposide 100mg/m2 days 1–5, and mitoxantrone 8mg/m2 days 1–3. Treatment emergent non-hematological toxicities included mucositis (4 patients, ≤ grade 2) and diarrhea (2 patients, ≤ grade 3). Two out of 6 patients (33%) at DL2 failed to recover absolute neutrophils (ANC) to 500/mcL by Day 42, and this was judged a potentially treatment related toxicity given lack of residual leukemia in day 14 marrows. Seven of 9 (78%) day 14 marrows were markedly hypocellular or aplastic, and two showed residual leukemia. Four out of 10 patients (40%) showed complete remission (CR – 2 patients) or remission with incomplete hematopoietic recovery (CRi – 2 patients). Three patients survive in remission 34, 98, and 236 days from enrollment. We conclude that the clofarabine, etoposide and mitoxantrone combination has acceptable toxicity and is an active regimen for significantly pretreated acute myelogenous leukemia. The total response rate compares favorably with other AML salvage regimens. As there has been delayed myeloid recovery at higher doses, we are pursuing DL1. The activity of this regimen is potentially non-crossresistant with ara-C, therefore larger studies are justified. Currently, patients are enrolling in an expanded cohort at the recommend phase 2 dose. Disclosures: Claxton: Genzyme: Research Funding. Off Label Use: Clofarabine for AML therapy.

Treatment-Related Myelodysplastic Syndrome and Acute Myelogenous Leukemia in Patients Treated With Ibritumomab Tiuxetan Radioimmunotherapy

2007 ◽  
Vol 25 (27) ◽  
pp. 4285-4292 ◽  
Author(s):  
Myron S. Czuczman ◽  
Christos Emmanouilides ◽  
Mohamed Darif ◽  
Thomas E. Witzig ◽  
Leo I. Gordon ◽  
...  
Keyword(s):  
Myelodysplastic Syndrome ◽  
Acute Myelogenous Leukemia ◽  
Chromosomal Abnormalities ◽  
Alkylating Agents ◽  
Nucleoside Analogs ◽  
Myelogenous Leukemia ◽  
Compassionate Use ◽  
Ibritumomab Tiuxetan ◽  
Cytogenetic Aberrations ◽  
Acute Myelogenous

PurposeTo investigate the incidence of treatment-related myelodysplastic syndrome (t-MDS) and treatment-related acute myelogenous leukemia (t-AML) after treatment with ibritumomab tiuxetan radioimmunotherapy.Patients and MethodsAnalysis of the incidence of t-MDS and t-AML in 746 patients with non-Hodgkin's lymphoma (NHL) treated with the ibritumomab tiuxetan regimen in registration and compassionate-use trials between 1996 and 2002.ResultsNineteen patients (2.5%) developed t-MDS or t-AML at a median follow-up of 4.4 years (range, 0 to 9.3). These malignancies were diagnosed at a median of 5.6 years (range, 1.4 to 13.9) after the diagnosis of NHL and 1.9 years (range, 0.4 to 6.3) after radioimmunotherapy. The annualized rates were 0.3% per year after the diagnosis of NHL and 0.7% per year after treatment. Most patients with t-MDS or t-AML had multiple cytogenetic aberrations, commonly on chromosomes 5 and 7, suggesting an association with previous exposure to chemotherapy.ConclusionAnalysis of data from patients in registration and compassionate-use trials suggests that the annualized incidences of t-MDS and t-AML are consistent with that expected in patients with NHL who have had extensive previous chemotherapy treatment and do not appear to be increased after treatment with the ibritumomab tiuxetan regimen. Cytogenetic testing before treatment with radioimmunotherapy may identify existing chromosomal abnormalities in previously treated patients, particularly those who have been treated with alkylating agents and purine nucleoside analogs and would be at higher risk for t-MDS or t-AML.

scholarly journals Fournier’s gangrene as an initial manifestation of acute promyelocytic leukemia: A case report and review of the literature

2019 ◽  
Vol 7 ◽  
pp. 2050313X1983442 ◽  
Author(s):  
Anahita Mostaghim ◽  
Muhammad Dhanani ◽  
Robin R Ingalls
Keyword(s):  
Acute Promyelocytic Leukemia ◽  
Acute Myelogenous Leukemia ◽  
Case Reports ◽  
Fournier’S Gangrene ◽  
Promyelocytic Leukemia ◽  
Myelogenous Leukemia ◽  
Fournier's Gangrene ◽  
Initial Manifestation ◽  
Surgical Services ◽  
Acute Myelogenous

Fournier’s gangrene is classically associated with diabetes mellitus and alcohol use disorder. While it is associated with chemotherapy, there are few case reports of Fournier’s gangrene as the initial presentation of acute myelogenous leukemia. A 38-year-old male presented with progressive scrotal swelling and hematochezia. Blood cell count showed depression of all cell lines without myeloblasts. He received broad-spectrum antibiotics and underwent surgical debridement once. Urgent bone marrow biopsy confirmed acute promyelocytic leukemia. The patient was started on chemotherapy. He was discharged without relapse of the infection. This is the fourth case of acute myelogenous leukemia presenting as Fournier’s gangrene in the literature and the only case to have survived. This brings forth a possible diagnostic consideration in patients without obvious predisposing risk factors for Fournier’s gangrene, particularly in those with pancytopenia. Coordination with surgical services as well as hematology/oncology specialists is imperative to survival of these dual diagnosis patients.

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