Background: Acute myelogenous leukemia (AML) is the most common disease of malignant hemopathy in adult. Although induction therapy induced the long complete remissions, but complications of this intensive therapy is very serious. Objectives: to evaluate the complications of induction chemotherapy in adult patients with acute myelogenous leukemia at Hue central hospital". Subject and method: 30 AML patients aged from 10 to 30 were treated at clinical hematology service, Hue central hospital from Mars, 2005 to July, 2006. The diagnosis of AML based on FAB classification. Induction therapy consisted of a combination of cytarabin 100mglm2/day given by continuous IV over 7 days and daunorubicin 45mg/m2/day for 3 days. Complications were evaluated based on toxicity grade of WHO. \r\n', u'Results: Alopecia was the most common complications (100%) but good recovery. Gastrointestinal toxicity included: nausea and vomiting (6.6%), oral mucositis (40%) and diarrhea (30%) Cerebral hemorrhage due thrombocytopenia (6.66%) and neutropenic septicemia (20%) are the most severe complications. Acute complications on cardio - vascular system were rare and only mild degree. Conclusion: The complications of induction chemotherapy in adult patients with acute myelogenous leukemia occur at many organs with different degrees. Among of them, bone marrow suppression is the most severe complication with cerebral hemorrhage due thrombocytopenia and neutropenic septicemia which are fatal complications in theses patients. \r\n', u'\r\n', u'
Leukemia ; Myeloid ; Acute/ complications ; pathology ; drug therapy

Background: Aplastic anemia following chemotherapy of acute leukemia is a common complication, which may lead to severe consequences. Objective: To study characteristics of aplastic anemia occurred in ccute myelogenous leukemia (AML) patients, following chemotherapy. Subjects and methods: A prospective study was carried out in 50 AML patients treated at National Institute of Hematology and Blood Transfusion from Aug 2005 to Dec 2006. These patients were treated by induction chemotherapy with "3+7" regime. Result: Aplastic anemia had been seen in 100% patients. Characteristics of this condition were poor marrow cells (average marrow cell count was 15.1\xb112.6 G/l) and strongly decreased counts of hemoglobin, white blood cells and platelets. Hemoglobin, white blood cell and platelet counts at the lowest level were 83.32 g/l; 0.96 G/l; 30.18 G/l; respectively. This situation prolonged for 3-4 weeks and changed into the most severe condition at the end of second week after chemotherapy. Infection frequency was 92%. Conclusion: Aplastic anemia following chemotherapy of AML patients is a common complication with severe consequences such as significant decrease of WBC and platelet counts, which may lead to opportunistic infection. Hence, this complication must be monitored, detected and treated promptly. \r\n', u'\r\n', u'
Leukemia ; Myeloid ; Acute/ pathology ; prevention & ; control ; complications ; drug therapy ; Anemia ; Aplastic/ blood ; complications ; pathology

Female ; Humans ; Leukemia, Myeloid, Acute ; complications ; etiology ; Middle Aged ; Myelodysplastic Syndromes ; complications ; etiology ; Uterine Cervical Neoplasms ; complications ; drug therapy ; radiotherapy

OBJECTIVETo study the antifungal treatment and intensive chemotherapy in children with acute leukemia and invasive aspergillosis.

METHODSThe diagnosis and treatment of 4 cases of childhood acute leukemia complicated by invasive aspergillosis between July 2007 and July 2008 were studied retrospectively.

RESULTSThree children who underwent remission induction chemotherapy for ALL and one who underwent consolidation chemotherapy for AML developed invasive aspergillosis. One child with proven aspergillosis and 3 with possible aspergillosis all had halo sign on CT at diagnosis. Voriconazole or amphotericin B was given as primary therapy. Improvements of fungal lesions were shown by CT after two to four weeks of antifungal therapy. Complete radiologic remissions were achieved between 4 months and one year. The intensive chemotherapy schedule was continued in all of 4 cases. The median time from fungal infection to the continuation of chemotherapy was 35 days. None showed recurrence of fungal infection.

CONCLUSIONSThe halo sign on CT may be a reliable indicator for the early diagnosis of invasive aspergillosis. The preemptive antifungal therapy on the basis of the identification of a halo sign and the reversal of immunosuppression may improve the outcome of invasive aspergillosis. Prolonged antifungal treatment during subsequent cycles of chemotherapy permits completion of scheduled intensive chemotherapy without fungal recurrence.

Antifungal Agents ; therapeutic use ; Aspergillosis ; drug therapy ; Child ; Child, Preschool ; Female ; Humans ; Leukemia, Myeloid, Acute ; complications ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications

Scopulariopsis brevicaulis is a soil fungus normally associated with onychomycosis. It causes subcutaneous infection in immunocompromised patients and is rarely isolated from blood. A case of systemic Scopulariopsis brevicaulis infection was reported in a patient with acute myeloid leukemia. The patient developed persistent fever that did not respond to wide spectrum antibiotics and amphotericin B. Scopulariopsis brevicaulis was the only pathogen isolated from blood cultures. The fever subsided with itraconazole and there was no recurrence of fungal infection with prolonged maintenance of oral itraconazole.
Acute Disease ; Antifungal Agents/*therapeutic use ; Immunocompromised Host ; Itraconazole/*therapeutic use ; Leukemia, Myeloid/*complications ; Mycoses/*drug therapy ; Mycoses/*microbiology ; Opportunistic Infections/*drug therapy ; Opportunistic Infections/*microbiology

OBJECTIVETo summarize the clinical characteristics, laboratory findings and prognosis of patients with Down syndrome-related acute leukemia (DS-AL).

METHODSThe clinical data, laboratory findings, chemotherapy and prognosis of 21 children with DS-AL were analyzed.

RESULTSMost of the children had disease onset of leukemia at 1 to 5 years of age (85.7%), and acute myeloid leukemia accounted for 57.1% of these cases; 61.9% of the patients had increased lactate dehydrogenase level by 2 folds or more. Of the 13 cases undergoing echocardiaography, 10 (67.9%) showed abnormal findings, and complex congenital heart disease was common (38.5%). Six of the children received chemotherapy and complete remission was achieved in 4 cases; 2 patients died of infection, and the treatment-related mortality was 33.3%. The 2 patients receiving reduced intensive chemotherapy have so far had event-free survival for 21 and 43 months.

CONCLUSIONAcute myeloid leukemia is the most common subtype of DS-AL. Patients with DS-AL are sensitive to chemotherapy and the prognosis was favorable with reduced intensive chemotherapy.

Antineoplastic Combined Chemotherapy Protocols ; Child, Preschool ; Disease-Free Survival ; Down Syndrome ; complications ; Humans ; Infant ; Leukemia, Myeloid, Acute ; complications ; drug therapy ; Prognosis ; Remission Induction

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Azacitidine ; administration & dosage ; analogs & derivatives ; Female ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; etiology ; Male ; Myelodysplastic Syndromes ; complications ; pathology ; Treatment Outcome

OBJECTIVE: To investigate the clinical features of acute myeloid leukemia patients with hemophagocytic syndrome. METHODS: The clinical data of 2 patients with acute myeloid leukemia complicated with hemophagocytic syndrome were collected, and the clinical characteristics and treatment outcomes were analyzed. RESULTS: There were two patients with acute myeloid leukemia, including 1 male and 1 female，aged for 67 and 40 years old，respectively. Hemophagocytic syndrome occurred in one patient after induction therapy for acute myeloid leukemia and one patient after consolidation therapy. Both of the patients with hemophagocytic syndrome showed fever, hemocytopenia, high ferritin, high titer sCD25 levels and hemophagocytes in bone marrow. After achieved anti-infection, glucocorticoid, human immunoglobulin and etoposide regimens treatment, hemophagocytic syndrome was controlled in both of the two patients. One patient failed to induce acute myeloid leukemia and one patient achieved complete remission. CONCLUSION Acute myeloid leukemia complicated with hemophagocytic syndrome is rare. Early identification, early anti-infection combined with HLH94 regimen can control hemophagocytosis and improve prognosis.
Aged ; Antineoplastic Combined Chemotherapy Protocols ; Bone Marrow ; Female ; Humans ; Leukemia, Myeloid, Acute/drug therapy* ; Lymphohistiocytosis, Hemophagocytic/complications* ; Male ; Prognosis ; Treatment Outcome

This is a case report on a 35-year-old man with acute myelogenous leukemia who presented fever and intermittent mucoid loose stool to the emergency center. He had been taking voriconazole for invasive pulmonary aspergillosis. The flexible sigmoidoscopy was consistent with the diagnosis of pseudomembranous colitis.
Adult ; Antifungal Agents/*adverse effects ; Enterocolitis, Pseudomembranous/*chemically induced/pathology ; Humans ; Invasive Pulmonary Aspergillosis/complications/drug therapy ; Leukemia, Myeloid, Acute/complications ; Male ; Opportunistic Infections/complications/drug therapy ; Pyrimidines/*adverse effects ; Triazoles/*adverse effects

The diagnosis of incracranial tuberculoma in immune-compromised hosts is often difficult because conventional magnetic resonance (MR) imaging of tuberculoma reveals various findings and neurologic symptoms are not typical. Here, we report a case of a 54-yr old man with multiple intracranial tuberculoma who was treated for acute myeloid leukemia. He complained of right-side paresthesia after the third consolidation chemotherapy without leukemic relapse and fever. MR imaging of the brain showed multiple ring-enhanced lesions in the cerebrum, cerebellar hemisphere, and pons. The lesions appeared to mimic a metastatic tumor or abscess. Cerebrospinal fluid analysis showed no abnormal cells, but the level of adenosine deaminase was elevated (28.8 IU/L, normal 0-8). Stereotactic brain biopsy was performed, but only reactive gliosis was observed. To confirm diagnosis, an open brain biopsy was performed. The histopathology demonstrated chronic granulomatous inflammation with caseous necrosis. Tuberculous-polymerase chain reaction of the biopsy showed a positive result. He was treated with anti-tuberculosis medication and a high dose of steroid. Paresthesia improved, and follow-up brain MR imaging showed the decreased size and numbers of ring-enhanced lesions and improvement of perilesional edema 1 month after treatment. Here, we report on an interesting case of intracranial tuberculoma in acute myeloid leukemia.
Antitubercular Agents/therapeutic use ; Brain Neoplasms/*diagnosis ; Diagnosis, Differential ; Humans ; Leukemia, Myeloid, Acute/*complications ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Sarcoma, Myeloid/*diagnosis ; Tuberculoma, Intracranial/complications/*diagnosis/drug therapy