ABSTRACT
Caso clínico: paciente masculino de 81 años de edad, con cuadro de 24 horas de evolución secundario a caída, caracterizado por somnolencia, desorientación en persona, tiempo y espacio, incontinencia urinaria y dificultad para la deambulación, motivo por el cual se le efectúa una tomografía simple de cráneo encontrándose hematomas subdurales bilaterales, presenta episodios de sangrado recurrente y leucocitosis sostenida , en frotis de sangre periférica se observó 28% de blastos por lo que se realiza una biopsia de medula ósea descubriéndose un cariotipo medular compatible con leucemia mieloide aguda, debido a sus características clínicas y a su mala evolución fue catalogado como paciente paliativo. Conclusiones: la leucemia mieloide aguda es una patología hematológica cuya evolución al no ser detectada genera un alto grado de mortalidad, sobre todo en el adulto mayor comórbido.
It was presented a clinical case of a male patient of 81 years of age, with a 24-hour of secondary evolution to a fall. It was characterized by drowsiness, disorientation in person, time and space, urinary incontinence and difficulty in walking, that was why a simple skull tomography was performed, in which bilateral subdural hematomas were found. The patient presented episodes of recurrent bleeding and sustained leukocytosis. Peripheral blood smear showed 28% of blasts, so a bone marrow biopsy was performed, revealing a medullary karyotype compatible with acute myeloid leukemia. The patient was classified as palliative due to its clinical characteristics and evolution. The hematological pathology above was potentially fatal. If this one was not detected early, it would generate an accelerated unfavorable evolution, especially in the elderly comorbid, as occurred in the case presented.
Subject(s)
Humans , Male , Aged, 80 and over , Hematologic Neoplasms , Hematologic Diseases , Hemic and Lymphatic Diseases , Paraneoplastic Syndromes , Neoplasms , Neoplastic ProcessesABSTRACT
Objective To explore the specific mechanism of ginsenoside Rh2(S) inducing the apoptosis of leukemia cells. Methods The effect of Rh2(S) on proliferation of leukemia cells K562 and KG1a was measured by cell counting kit-8 assay (CCK-8 assay). The growth states of cells were observed under the inverted phase microscope, and cell cycle distribution, and apoptosis were determined by flow cytometry (FCM). The expression levels of HDAC6, HSP90, Akt, GSK-3β, β-catenin, and cell cycle apoptosis related proteins were ascertained by Western blotting. Results The results of CCK-8 showed that Rh2(S) had the most obvious inhibitory effect on the proliferation of leukemia cells. Rh2(S) significantly induced apoptosis and led to cell cycle arrest at G0/G1 phase of leukemia cells by FCM. While the microscope observation showed that the number of cells was decreased and normal cell morphology changed. Rh2(S) decreased the expression of Bcl-2, Cyclin D1, HDAC6, HSP90, p-Akt, and β-catenin and increased the expression of Bax, Ac-α-tubulin, and GSK-3β by Western blotting. Conclusion Rh2(S) can effectively inhibit the proliferation and promote the apoptosis of K562 and KG1a cells, its specific mechanism may relate to inhibitting the expression of HDAC6, resulting in a decline in the expression of HSP90, so as to further inhibit the activity of Akt activation of GSK-3, and finally inhibit Wnt/β-catenin pathway.
ABSTRACT
Leukemia may be accompanied by two types of skin lesion. One is nonspecific lesion, called leukemids and the other is leukemia cutis, which is generally regarded as being a specific sign of dissemination of aggressive systemic leukemia to the skin. It is known to be associated with poor prognosis. Although some cases of leukemia cutis have been reported in Korea, however, there has been reported few cases of leukemia cutis which occurred in chronic lymphocytic leukemia (CLL). Recently we have experienced a case of leukemia cutis associated with CLL, so report this case with review of literatures.