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: In recent years, Vietnam has applied four methods (morphology, cell chemistry, immune marker classification, cyto genetic) in diagnosis and used multi-chemotherapy in treatment for acute myelogenous leukemia (AML)\r\n', u'Objectives: To initially determine some fusion gene transcripts in the acute myelogenous leukemia patients by applying PCR technique. Subject and method: The study included 19 patients with acute myelogenous leukemia treated in National Institute of Hematology and Blood Transfusion and Bachmai Hospital from April 2007 to August 2007. RNA were extracted from leukemic cells and PCR for AML1/ETO, CBFP/MYH11, PMR/RARa fusion transcript was done. Results: Number of male patients was 6 (32%), female patients was 13 (68%). The average age of these patients was 32.67 \xb113.62. There were three M4, M4eo patients with AML1/ETO gene (accounting for 16%), two M2, M4 patients with CBF/MYH1 gene and type F of genetic modification accounting for 11%), two M3 patients with PMR/RAR\u03b1 and Bcr3 of genetic modification (accounting for 11%). Conclusion: Results of the study did not differ significantly from other researches in the world. This study showed the need of applying the PCR technique in determining fusion gene transcript together with traditional cyto-genetic method.\r\n', u'\r\n', u'
Leukemia ; Myeloid ; Acute/ blood ; pathology ; complications ; Polymerase Chain Reaction

Adolescent ; Humans ; Leukemia, Myeloid, Acute ; etiology ; pathology ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; pathology

A rare case of spinal epidural granulocytic sarcoma (GS) preceding acute myelogenous leukemia is described. A 10-year-old boy presented with lower leg weakness. The initial diagnosis was a histiocytic lymphoma, and he was treated accordingly. No evidence of bone marrow involvement was found at that time. The correct diagnosis of epidural GS was made possible in retrospect by using immunoperoxidase staining for lysozyme fourteen months later when the patient showed the full-blown features of leukemia. This rare tumor should be considered in the differential diagnosis of an epidural mass with cord compression in patients with or even without acute leukemia, because early diagnosis followed by appropriate combined chemotherapy and radiation may obviate surgical intervention and eventually prevent leukemic transformation.
Child ; Epidural Neoplasms/*complications/pathology ; Humans ; Immunoenzyme Techniques ; Leukemia, Myeloid/*complications/pathology ; Leukemia, Myeloid, Acute/*complications/pathology ; Male ; Neoplasms, Second Primary

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

Granulocytic sarcoma (GS) is an uncommon and localized extramedullary tumor composed of immature granulocytic cells. Most GS reported in large series were not associated with overt acute myelogenous leukemia. Gastric perforation occurred during prednisolone therapy in a 72-year-old Japanese male with a four-month history of a myelofibrosis-like state. Subtotal gastrectomy was performed for a suspected gastric ulcer perforation. Gastric histologic, immunohistochemical and cytochemical examination revealed diffuse infiltration by sheets of myeloblasts and promyelocytes with scant or moderately abundant cytoplasm including a few eosinophilic myelocytes. Bone marrow study done in one month after the operation disclosed refractory anemia with excess of blasts (RAEB). Leukemic transformation occurred two months later, and a subcutaneous tumor appeared on the forehead. The forehead tumor predominantly consisted of myeloblasts without evidence of maturation. Both the stomach and forehead tumors were examined immunohistochemically with a panel of monoclonal antibodies (LCA, L26, MT1, UCHL1, OPD4, LN-1, LN-2, LN-3, MB1, Leu-M1, PM) and polyclonal antibodies (lysozyme, alpha 1-antitrypsin, alpha 1-antichymotrypsin, S-100 protein, lactoferrin), as well as naphthol-ASD-chloroacetate esterase staining to investigate and characterize the reliable marks for GS, and the patient was diagnosed as GS. We found that gastric GS may occur in a myelofibrosis-like state followed by RAEB of myelodysplastic syndrome and that naphthol-ASD-chloroacetate esterase staining and immunohistochemical detection of MT1, lysozyme, and alpha 1-antitrypsin were the most reliable markers for confirming the diagnosis of GS.
Aged ; Case Report ; Fatal Outcome ; Forehead ; Human ; Leukemia, Myeloid/*complications/pathology ; Male ; Myelodysplastic Syndromes/*complications/pathology ; Skin Neoplasms/complications/pathology ; Stomach Neoplasms/*complications/pathology ; Support, Non-U.S. Gov't

OBJECTIVE: To explore the genetic and clinical characteristics of near-tetraploidy/tetraploidy karyotype (NT/T) in patients with myelodysplastic syndrome (MDS). METHODS: Cytogenetic findings of 1576 inpatients with primary MDS were retrospective analyzed, among which 9 were diagnosed with NT/T. Clinical data including gender, age, morphology, genetic feature and prognosis were analyzed. RESULTS: The prevalence of MDS patients with NT/T (NT/T-MDS) among all cases was 0.57%. Karyotyping analysis suggested that eight MDS patients had sole NT/T, while the remainder one had a complex karyotype. In addition to the typical morphology of MDS, NT/T-MDS had unique morphology including huge blast, double-nuclear cell and irregular nuclear membrane. One NT/T-MDS patient gave up therapy, and the remaining eight underwent the first course of treatment, albeit with poor prognosis. Only one patient had complete remission, one had partial remission, three had no remission; and three had converted to acute myeloid leukemia. CONCLUSION NT/T-MDS is rare and has unique morphology. Generally, NT/T-MDS patients have poor prognosis. However, NT/T cannot be simply classified as high-risk group, but with consideration whether they have affected particular chromosomal structures as well as other clinical data.
Humans ; Karyotype ; Leukemia, Myeloid, Acute/complications* ; Myelodysplastic Syndromes/pathology* ; Prognosis ; Retrospective Studies ; Tetraploidy

Pleural effusion in chronic myeloid leukemia (CML) is poorly understood and rarely reported in the literature. When the pleural effusion is caused by leukemic pleural infiltration, the differential white blood cell count of the effusion is identical to that of the peripheral blood, and the fluid cytology reveals leukemic blasts. We report here a case of bilateral pleural involvement of atypical CML in an 83-yr old male diagnosed with pancreatic cancer with abdominal wall metastasis and incidental peripheral leukocytosis. Based on bone marrow examination, chromosome analysis and polymerase chain reaction he was diagnosed with Philadelphia chromosome negative, BCR/ABL gene rearrangement negative CML. Following 3 months of treatment with gemcitabine for pancreatic cancer, he developed bilateral pleural effusions. All stages of granulocytes and a few blasts were present in both the pleural fluid and a peripheral blood smear. After treatment with hydroxyurea and pleurodesis, the pleural effusion resolved.
Pleural Effusion/*etiology/pathology ; Male ; Leukemic Infiltration/*pathology ; Leukemia, Myeloid, Chronic/complications/*pathology ; Humans ; Aged, 80 and over ; Aged

OBJECTIVETo investigate the association between trisomy 21 abnormalities and the clinical and cytogenetic features of hematologic malignancies.

METHODSChromosome preparations were made on bone marrow cells by using direct method and/or unstimulated short-term cultures. Karyotypes were analyzed by R-banding.

RESULTSThirteen patients (1.5%) with acute myeloid leukemia (AML) including 6 cases of M5b, 8 (2.2%) with acute lymphoblastic leukemia (ALL) and 4 cases with other hematologic malignancies had acquired trisomy 21, and in 13 patients it occurred as the sole cytogenetic abnormality. The remaining had combination with other abnormalities. The median survival for the 19 patients with trisomy 21 was 9 months.

CONCLUSIONM5b was the major type in AML with sole acquired trisomy 21.Trisomy 21 as the sole abnormality appeared to have a poor prognosis.

Adolescent ; Adult ; Aged ; Down Syndrome ; complications ; Female ; Follow-Up Studies ; Hematologic Neoplasms ; complications ; genetics ; pathology ; Humans ; Karyotyping ; Leukemia, Myeloid, Acute ; complications ; genetics ; pathology ; Male ; Middle Aged ; Phenotype ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; genetics ; pathology ; Survival Rate

Child ; Humans ; Male ; Neoplasms, Second Primary ; etiology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; Sarcoma, Myeloid ; etiology ; pathology