1.The complications of induction chemotherapy in adult patients with acute myelogenous leukemia at Hue Central Hospital
Journal of Medical Research 2007;51(4):13-19
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
3.Renal Involvement of Chronic Myelogenous Leukemia Presenting as a Kidney Tumor.
Yonsei Medical Journal 2004;45(5):944-946
Renal involvement by leukemic cells is rare in chronic myelogenous leukemia (CML). Herein, this study reports a case of CML associated with renal involvement of leukemic cells, which occurred 1 and 1/2 years after the initial diagnosis. Abdomino-pelvic computed tomography revealed a 4.4 x4.2 cm-sized, low-density solid mass having a thick wall from the mid to lower pole of the left kidney. A peripheral blood analysis revealed blastic transformation of CML. The biopsied renal parenchyme was diffusely infiltrated by sheets of immature myeloid cells, polymorphonuclear leukocytes, and occasional eosinophils. Most of the infiltrating cells were positive for anti-neutrophil elastase, but negative for lymphoid markers. Therefore, differential diagnosis of a kidney tumor during the course of CML, especially in the time of blastic transformation, should be performed.
Aged
;
Female
;
Humans
;
Kidney Neoplasms/*pathology
;
Leukemia, Myeloid, Chronic/*pathology
4.Application PCR technique for analysis of fusion gene transcripts in the acute myelogenous leukemia
Phuong Minh Vu ; Vinh Quang Pham ; Hoa Khanh Bach ; Cuong Quoc Nguyen ; Phuong Minh Nguyen
Journal of Medical Research 2007;51(4):30-35
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
6.Spinal epidural granulocytic sarcoma preceding acute myelogenous leukemia.
Hoon KOOK ; Tai Ju HWANG ; Kyoung CHOE ; Dong Wook YANG ; Jong Hee NAM ; Chang Soo PARK
Journal of Korean Medical Science 1992;7(3):291-296
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
7.Mixed-phenotype acute leukemia: suboptimal treatment when the 2008/2016 WHO classification is used.
Alan POMERANTZ ; Sergio RODRIGUEZ-RODRIGUEZ ; Roberta DEMICHELIS-GOMEZ ; Georgina BARRERA-LUMBRERAS ; Olga BARRALES-BENITEZ ; Xavier LOPEZ-KARPOVITCH ; Alvaro AGUAYO-GONZALEZ
Blood Research 2016;51(4):233-241
BACKGROUND: Different criteria have been used to diagnose mixed-phenotype acute leukemia (MPAL), which has impacted the number of individuals diagnosed with this pathology. Better outcomes have been reported when using acute lymphoblastic leukemia (ALL)-type chemotherapy in the treatment of MPAL. METHODS: We compared the outcome of 4 groups of patients with MPAL. Group 1 included patients diagnosed using the 2008/2016 World Health Organization (WHO) classification; group 2 included patients diagnosed using the European Group for the Immunological Characterization of Leukemias (EGIL) criteria; group 3 included patients diagnosed using either the EGIL or the 2008/2016 WHO criteria; and group 4 was comprised of patients diagnosed with MPAL using the EGIL classification only. RESULTS: We found a significantly worse disease-free survival (groups 1-4) and overall survival (OS) (groups 2 and 3) when comparing MPAL patients to other acute leukemia (AL) patients. A significantly better OS was obtained in patients (groups 2-4) treated with ALL-type chemotherapy compared to acute myeloid leukemia (AML)-type regimens. CONCLUSION: In light of these results, and because a trend (P=0.06) was found with regard to a better OS in group 4 when compared to other AL patients, an argument can be made that the 2008/2016 WHO classification is underpowered to diagnose all MPAL cases, potentially resulting in the suboptimal treatment of some individuals with AL.
Classification*
;
Disease-Free Survival
;
Drug Therapy
;
Humans
;
Leukemia*
;
Leukemia, Myeloid, Acute
;
Pathology
;
Precursor Cell Lymphoblastic Leukemia-Lymphoma
;
World Health Organization
8.Intracranial granulocytic sarcoma (chloroma) in a nonleukemic patient.
Dong Heon YOON ; Kyung Ja CHO ; Yeon Lim SUH ; Chul Woo KIM ; Je G CHI ; Dae Hee HAN ; Young Joo BANG ; Byung Kook KIM ; Noe Kyeong KIM ; Han Ik CHO
Journal of Korean Medical Science 1987;2(3):173-178
Chloroma is a granulocytic sarcoma with it's characteristic greenish color. Recently there is an increased number of cases that are apparently aleukemic when the tumor mass is first presented. Recently we experienced a case of granulocytic sarcoma with characteristic green color (chloroma), which showed no evidence of leukemia in the bone marrow and peripheral blood. This patient presented headache, and was diagnosed brain tumor on computed tomography. A left parietal cranietomy was done to remove a large central dome-like mass, 8 cm, involving the dura with a slightly dusky greenish solid appearance. Compact nests of moderately mature granulocytes and immature cells comprised the tumor. Histochemical and electron microscopic studies confirmed these tumor cells as myeloid cells in varying stages of maturation. Several days after the operation, left cervical lymph nodes became palpated, and the biopsied lymph nodes revealed same neoplastic cells seen in the skull. However, bone marrow aspiration, biopsy and peripheral blood smears did not show any evidence of leukemia.
Adolescent
;
Brain Neoplasms/pathology/*surgery
;
Female
;
Humans
;
Leukemia, Myeloid/pathology/*surgery
9.Research progress on mechanism of MDS transformation into AML.
Lin-Lin WANG ; Chong GAO ; Bao-An CHEN
Journal of Experimental Hematology 2011;19(1):254-259
Myelodysplastic syndrome (MDS) is a clonal hematopoietic stem cell disorder characterized by ineffective hematopoiesis and a risk of transformation into acute leukemia. Approximately 30% of patients with MDS will progress and develop into acute myeloid leukemia (AML), especially in the patients with high-risk MDS, which can be named as secondary acute myeloid leukemia (sAML or MDS/AML). Generally, chemotherapy for sAML hardly has any efficacy. The only way to cure the patients with sAML is allogeneic hematopoietic stem cell transplantation, but unfortunately, only few patients are appropriate for transplantation. So it is important to study the mechanisms of progression of MDS to AML and to explore the potent drug for clinical use. This review summarizes the mechanism of MDS transformation into AML from chromosomal abnormality, aberrant DNA methylation and gene mutation, such as AML1/RUNX1 mutations, FLT3 mutations and PI-PLCβ1 mono-allelic deletion.
Chromosome Aberrations
;
DNA Methylation
;
Humans
;
Leukemia, Myeloid, Acute
;
genetics
;
pathology
;
Myelodysplastic Syndromes
;
genetics
;
pathology
10.Study complication of aplastic anemia following chemotherapy of acute myelogenous leukemia
Journal of Medical Research 2007;51(4):9-13
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