Asunto(s)
Sistema del Grupo Sanguíneo ABO/análisis , Tipificación y Pruebas Cruzadas Sanguíneas , Leucemia Eritroblástica Aguda/inmunología , Oligosacáridos/deficiencia , Adolescente , Pruebas de Aglutinación , Anemia/inducido químicamente , Anemia/inmunología , Anemia/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Incompatibilidad de Grupos Sanguíneos/prevención & control , Tipificación y Pruebas Cruzadas Sanguíneas/métodos , Prueba de Coombs , Citarabina/administración & dosificación , Citarabina/efectos adversos , Daunorrubicina/administración & dosificación , Daunorrubicina/efectos adversos , Transfusión de Eritrocitos , Resultado Fatal , Femenino , Humanos , Leucemia Eritroblástica Aguda/complicaciones , Leucemia Eritroblástica Aguda/tratamiento farmacológico , Oligosacáridos de Cadena Ramificada , Lectinas de Plantas , Transfusión de Plaquetas , Sepsis/etiologíaAsunto(s)
Anemia de Células Falciformes/complicaciones , Antidrepanocíticos/uso terapéutico , Aberraciones Cromosómicas , Hidroxiurea/uso terapéutico , Leucemia Eritroblástica Aguda/complicaciones , Síndromes Mielodisplásicos/complicaciones , Anemia de Células Falciformes/tratamiento farmacológico , Anemia de Células Falciformes/genética , Anemia de Células Falciformes/patología , Antineoplásicos/uso terapéutico , Cromosomas Humanos Par 17 , Cromosomas Humanos Par 5 , Células Clonales , Eritroblastos/metabolismo , Eritroblastos/patología , Resultado Fatal , Células Precursoras de Granulocitos/metabolismo , Células Precursoras de Granulocitos/patología , Humanos , Cariotipo , Leucemia Eritroblástica Aguda/tratamiento farmacológico , Leucemia Eritroblástica Aguda/genética , Leucemia Eritroblástica Aguda/patología , Masculino , Persona de Mediana Edad , Síndromes Mielodisplásicos/tratamiento farmacológico , Síndromes Mielodisplásicos/genética , Síndromes Mielodisplásicos/patologíaRESUMEN
Case 1. The laboratory findings of a hematological analysis of a 53-year-old woman with palpitations and dyspnea revealed the following: red blood cell (RBC) count: 9.4×10(5)/µL with 60.0 reticulocytes; Hb: 3.7 g/dL; mean corpuscular volume (MCV): 124.5 fL; white blood cell (WBC) count: 2,800/µL with 10.0% myeloblasts. Case 2. Similarly, a 42-year-old man with dizziness had a RBC count of 1.63×10(6)/µL with 24.0% reticulocytes, an Hb level of 6.0 g/dL, an MCV of 120.2 fL and a WBC count of 3,100/µL with 4.0% myeloblasts. Bone marrow aspirates in both patients confirmed a diagnosis of acute erythroid leukemia (AEL), which can present as marked macrocytic anemia with an MCV in excess of 120 fL and hemolysis.
Asunto(s)
Anemia Macrocítica/diagnóstico , Hemólisis/fisiología , Leucemia Eritroblástica Aguda/diagnóstico , Reticulocitosis/fisiología , Adulto , Anemia Macrocítica/sangre , Anemia Macrocítica/complicaciones , Diagnóstico Diferencial , Femenino , Humanos , Leucemia Eritroblástica Aguda/sangre , Leucemia Eritroblástica Aguda/complicaciones , Masculino , Persona de Mediana EdadAsunto(s)
Leucemia Eritroblástica Aguda/complicaciones , Vasculitis/complicaciones , Trasplante de Médula Ósea , Humanos , Leucemia Eritroblástica Aguda/terapia , Angiografía por Resonancia Magnética , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , Trasplante Homólogo , Vasculitis/diagnósticoRESUMEN
AML-M6 has a peak incidence in the seventh decade with slight male preponderance, and can also present at a younger age. The usual features are anaemia, thrombocytopenia, malaise, fatigue, easy bruising, epistaxis and petechiae. Splenomegaly may occur in 20-40 % of the cases but massive splenomegaly is rare presentation and have been only reported once in humans and once in animals. A 22 year Asian female, presented with fatigue, pallor, mild jaundice, exertional dyspnoea, epigastric pain, tender right hypochondrium and massive splenomegaly. Investigations revealed anaemia and thrombocytopenia, tear drop cells, basophilic stippling, piokilocytosis and anisochromia; increased uric acid and LDH. Abdominal ultrasound showed enlarged liver (22cm) and spleen (20cm). Bone marrow aspiration revealed 51% erythroid and 24% non-erythroid precursors, depressed leukopoeisis and megakarypoeisis. Erythroblasts were PAS and CD71 positive and also reacted to Antihaemoglobin-Antibody. This report highlights characteristic features and diagnostic criteria of erythroleukaemia, differential diagnosis of massive splenomegaly and their rare association.
Asunto(s)
Dolor Abdominal/diagnóstico por imagen , Médula Ósea/patología , Eritroblastos , Pruebas Hematológicas/métodos , Leucemia Eritroblástica Aguda , Esplenomegalia , Dolor Abdominal/etiología , Dolor Abdominal/patología , Dolor Abdominal/fisiopatología , Anemia/diagnóstico , Anemia/etiología , Antígenos CD/metabolismo , Diagnóstico Diferencial , Eritroblastos/metabolismo , Eritroblastos/patología , Femenino , Humanos , Leucemia Eritroblástica Aguda/complicaciones , Leucemia Eritroblástica Aguda/diagnóstico , Leucemia Eritroblástica Aguda/fisiopatología , Tamaño de los Órganos , Receptores de Transferrina/metabolismo , Esplenomegalia/diagnóstico , Esplenomegalia/etiología , Esplenomegalia/patología , Esplenomegalia/fisiopatología , Ultrasonografía , Adulto JovenAsunto(s)
Leucemia Eritroblástica Aguda/patología , Pancitopenia/patología , Policitemia Vera/patología , Reticulocitos/patología , Antígenos CD/análisis , Azacitidina/uso terapéutico , Recuento de Células Sanguíneas , Diferenciación Celular , Eritroblastos/patología , Resultado Fatal , Humanos , Leucemia Eritroblástica Aguda/complicaciones , Leucemia Eritroblástica Aguda/diagnóstico , Leucemia Eritroblástica Aguda/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Pancitopenia/complicaciones , Pancitopenia/diagnóstico , Pancitopenia/tratamiento farmacológico , Policitemia Vera/complicaciones , Policitemia Vera/diagnóstico , Policitemia Vera/tratamiento farmacológicoAsunto(s)
Leucemia Eritroblástica Aguda/complicaciones , Leucemia Eritroblástica Aguda/patología , Mieloma Múltiple/complicaciones , Mieloma Múltiple/patología , Humanos , Inmunofenotipificación , Leucemia Eritroblástica Aguda/terapia , Masculino , Persona de Mediana Edad , Mieloma Múltiple/terapia , PronósticoAsunto(s)
Antifúngicos/administración & dosificación , Endoftalmitis/tratamiento farmacológico , Infecciones Fúngicas del Ojo/tratamiento farmacológico , Pirimidinas/administración & dosificación , Triazoles/administración & dosificación , Adulto , Trasplante de Células Madre de Sangre del Cordón Umbilical , Endoftalmitis/complicaciones , Endoftalmitis/patología , Infecciones Fúngicas del Ojo/complicaciones , Infecciones Fúngicas del Ojo/patología , Femenino , Humanos , Inyecciones Intravítreas , Leucemia Eritroblástica Aguda/complicaciones , Leucemia Eritroblástica Aguda/terapia , VoriconazolRESUMEN
A case of systemic mastocytosis associated with a clonal haematological non-mast cell lineage disease (SM-AHNMD), where the associated disease is acute erythroid leukaemia (erythroid/myeloid type), is reported. Interestingly, molecular studies showed the KIT(D816V+) mutation not only in the mast cells, but also in the myeloid blast population and the leukaemic erythroid cells. As is the case with most erythroid leukaemias, the patient had a very aggressive clinical course and died shortly after diagnosis. It is believed that this is the first reported case of systemic mastocytosis with erythroid leukaemia where the KIT(D816V+) mutation was detected in all three cell types. Molecular findings provide evidence for derivation of these seemingly morphologically distinct lesions from the same clonal precursor cell. From a practice standpoint, this case illustrates the importance of definitively diagnosing the associated non-mast cell lineage disease due to its prognostic implications.
Asunto(s)
Leucemia Eritroblástica Aguda/genética , Mastocitosis Sistémica/genética , Mutación , Proteínas Proto-Oncogénicas c-kit/genética , Resultado Fatal , Humanos , Leucemia Eritroblástica Aguda/complicaciones , Leucemia Eritroblástica Aguda/patología , Mastocitosis Sistémica/complicaciones , Mastocitosis Sistémica/patología , Persona de Mediana Edad , Células Madre Neoplásicas/patología , PronósticoRESUMEN
A 53-year-old man was admitted with pancytopenia, fever and splenomegaly. Biochemistry showed increased ferritin levels. Bone marrow examination revealed increased erythrocytic precursors (94.9%) and active hemophagocytosis. Pure erythroid leukemia with hemophagocytic syndrome (HPS) was diagnosed. Induction chemotherapy comprising idarubicin and cytarabine was administered and steroid pulse therapy was added. Complete remission was attained, and HPS also improved. However, leukemia relapsed during chemotherapy and the patient died. This is the first report of pure erythroid leukemia complicated with HPS.
Asunto(s)
Leucemia Eritroblástica Aguda/complicaciones , Linfohistiocitosis Hemofagocítica/etiología , Antineoplásicos/uso terapéutico , Médula Ósea/patología , Citarabina/uso terapéutico , Resultado Fatal , Humanos , Idarrubicina/uso terapéutico , Leucemia Eritroblástica Aguda/tratamiento farmacológico , Leucemia Eritroblástica Aguda/genética , Leucemia Eritroblástica Aguda/patología , Linfohistiocitosis Hemofagocítica/tratamiento farmacológico , Linfohistiocitosis Hemofagocítica/patología , Masculino , Metilprednisolona/uso terapéutico , Persona de Mediana EdadRESUMEN
Bacteremia due to Capnocytophaga sputigena occurred in a 4-year and 9-month-old Japanese girl patient with acute erythroblastic leukemia in Shinshu University Hospital, Japan. On her admission to the hospital, she had a temperature of 38.2 degrees C with canker sore. Prior to the commencement of chemotherapy, peripheral blood culture was carried out with the BacT/Alert 3D System ver. 4.00D (bioMerieux Japan Ltd., Tokyo, Japan) using both the PF and the SN bottles. At 48 hrs of incubation, the System showed the positive sign only in the anaerobic SN bottle for bacterial growth. The strain isolated from the SN bottle was morphologically, biochemically, and genetically characterized, and finally identified as Capnocytophaga sputigena. The causative Capnocytophaga sputigena isolate was found to be a beta-lactamase-producer demonstrating to possess cfxA3 gene. The gene responsible for the production of CfxA3-beta-lactamase was proved to be chromosome-encoded, by means of southern hybridization analysis. This was the first case of bacteremia caused by chromosome-encoded CfxA3-beta-lactamase-producing Capnocytophaga sputigena.
Asunto(s)
Bacteriemia/microbiología , Capnocytophaga/aislamiento & purificación , Cromosomas Bacterianos , Leucemia Eritroblástica Aguda/complicaciones , beta-Lactamasas/biosíntesis , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Bacteriemia/complicaciones , Bacteriemia/diagnóstico , Bacteriemia/tratamiento farmacológico , Capnocytophaga/efectos de los fármacos , Capnocytophaga/enzimología , Preescolar , Femenino , Humanos , Pruebas de Sensibilidad Microbiana , beta-Lactamasas/genéticaAsunto(s)
Trasplante de Células Madre de Sangre del Cordón Umbilical/métodos , Rechazo de Injerto , Leucemia Eritroblástica Aguda/terapia , Acondicionamiento Pretrasplante/métodos , Adulto , Trasplante de Células Madre de Sangre del Cordón Umbilical/efectos adversos , Infecciones por Bacterias Gramnegativas/etiología , Humanos , Leucemia Eritroblástica Aguda/complicaciones , Masculino , Inducción de Remisión/métodos , Stenotrophomonas maltophiliaRESUMEN
We report on two cases of patients who developed diabetes insipidus (DI) before acute erythroleukaemia (EL). A brain MRI showed an empty sella turcica in one case and hypothalamo-hypophyseal peduncle damage in the second case. Reduced levels of TGF-beta1 and Vitamin D3, with associated EVI-1 over-expression and karyotypic abnormalities were documented. These two cases show specific chromosomal/molecular alterations in EL with DI. The hypothesis of pituitary involvement in erythroleukemogenesis is discussed.
Asunto(s)
Diabetes Insípida/complicaciones , Síndrome de Silla Turca Vacía/inducido químicamente , Enfermedades Hipotalámicas/complicaciones , Leucemia Eritroblástica Aguda/complicaciones , Hipófisis/patología , Adulto , Colecalciferol/sangre , Aberraciones Cromosómicas , Proteínas de Unión al ADN/genética , Proteínas de Unión al ADN/metabolismo , Diabetes Insípida/diagnóstico , Diabetes Insípida/metabolismo , Síndrome de Silla Turca Vacía/diagnóstico , Síndrome de Silla Turca Vacía/metabolismo , Femenino , Humanos , Enfermedades Hipotalámicas/diagnóstico , Enfermedades Hipotalámicas/metabolismo , Leucemia Eritroblástica Aguda/diagnóstico , Leucemia Eritroblástica Aguda/metabolismo , Proteína del Locus del Complejo MDS1 y EV11 , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Proto-Oncogenes/genética , Factores de Transcripción/genética , Factores de Transcripción/metabolismo , Factor de Crecimiento Transformador beta1/metabolismoRESUMEN
We report the case of a 78-year-old man who presented with acute myeloid leukaemia showing subpopulations of cells expressing platelet-associated markers and the presence of a pan-myeloid component, besides glycophorin A-positive cells. Most of the immature cells had a proerythroblast-like morphology and we classified this case as an FAB-M6 variant, as suggested by Bain (1). According to the WHO classification, this leukaemia fulfilled the criteria of'AML with multilineage dysplasia' (2). Immunophenotyping characteristics showed two distinct aberrant subpopulations, a young pan-myeloid (CD45+ with low density, CD34+, CD117+, CD13+, CD33+, partial cytoplasmic myeloperoxidase (MPO)+) population with platelet-associated markers (CD41+, CD42+, CD61+) and a CD45+, CD117+, CD34- population with partial CD235a positivity indicative for erythroid maturation. This case belongs to the group of 'early' erythroblastic leukaemias where a subset of progenitor cells present with erythroid-megakaryocyte bipotentiality or are blocked at an early BFU-E (burst-forming unit erythrocyte)-like stage of erythroid differentiation (11, 12, 13).
Asunto(s)
Células de la Médula Ósea/patología , Leucemia Eritroblástica Aguda/diagnóstico , Leucemia Megacarioblástica Aguda/diagnóstico , Anciano , Biopsia con Aguja , Diagnóstico Diferencial , Resultado Fatal , Humanos , Inmunofenotipificación , Leucemia Eritroblástica Aguda/complicaciones , Leucemia Eritroblástica Aguda/inmunología , Leucemia Megacarioblástica Aguda/complicaciones , Leucemia Megacarioblástica Aguda/inmunología , MasculinoRESUMEN
Therapy-related acute myeloid leukemias arise as a result of cytotoxic chemotherapy and/or radiation therapy. The most common types of acute myeloid leukemia arising in this setting are acute myeloid leukemia with maturation, and lesser numbers of acute myelomonocytic leukemia, acute monocytic leukemia, acute erythroleukemia, or acute megakaryocytic leukemia. We present a patient with multiple myeloma who was treated with melphalan and 4 years later developed acute erythroid leukemia. The morphologic diagnosis of pure erythroid leukemia developing in the setting of multiple myeloma may be challenging.
Asunto(s)
Epistaxis/complicaciones , Leucemia Eritroblástica Aguda/complicaciones , Mieloma Múltiple/complicaciones , Debilidad Muscular/complicaciones , Enfermedad Aguda , Anciano de 80 o más Años , Antineoplásicos Alquilantes/efectos adversos , Humanos , Leucemia Eritroblástica Aguda/inducido químicamente , Leucemia Eritroblástica Aguda/patología , Leucemia Mieloide , Masculino , Melfalán/efectos adversos , Mieloma Múltiple/tratamiento farmacológico , Mieloma Múltiple/patologíaRESUMEN
Cerebral aspergillosis is associated with very high mortality in immunocompromised hosts. Conventional antifungal agents like amphotericin-B and itraconazole are almost ineffective in cerebral aspergillosis. Newer azoles have been shown to penetrate the blood, cerebrospinal fluid barrier and achieve effective fungicidal concentrations. These newer azoles may change the outlook of this fatal condition. We report here a patient with cerebral aspergillosis who was successfully treated with voriconazole.
Asunto(s)
Aspergilosis/tratamiento farmacológico , Aspergillus fumigatus , Absceso Encefálico/tratamiento farmacológico , Infecciones Fúngicas del Sistema Nervioso Central/tratamiento farmacológico , Leucemia Eritroblástica Aguda/tratamiento farmacológico , Pirimidinas/uso terapéutico , Triazoles/uso terapéutico , Adulto , Aspergilosis/complicaciones , Absceso Encefálico/complicaciones , Infecciones Fúngicas del Sistema Nervioso Central/complicaciones , Humanos , Leucemia Eritroblástica Aguda/complicaciones , Masculino , Telencéfalo , VoriconazolRESUMEN
Intense myelofibrosis is rarely associated with de novo acute myeloid leukaemia (AML) except in acute megakaryoblastic leukaemia (AML-M7) where there is diffuse marrow fibrosis as a consequence of proliferation of neoplastic myeloid cells. AML associated with significant myelofibrosis developing both de novo or secondary to primary (idiopathic) myelofibrosis is characterised by a fulminant course and extremely poor prognosis, primarily due to treatment-resistant disease. The prognostic value of degree of marrow fibrosis in de novo AML has been poorly investigated. We describe a case of extensive myelofibrosis associated with acute erythroblastic leukaemia (AML-M6) that responded to induction therapy of the leukaemia.