ABSTRACT
The institutional review board of our hospital approved FLAG-MG therapy (G-CSF 300 microg day 1-6, fludarabin 30 mg/m(2) day 2-6, Ara-C 1 g/m(2) day 2-6, mitoxantrone 5 mg/m(2) day 2-4, gemtuzumab ozogamicin 3 mg/m(2) day 9) for relapsed or refractory elderly acute myeloid leukemia patients. We conducted this therapy for two refractory patients aged 56 and 63 and one relapsed 58-year-old patient. All three patients were induced complete remission after FLAG-MG therapy without serious complications.
Subject(s)
Aminoglycosides/administration & dosage , Antibodies, Monoclonal/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Leukemia, Myeloid, Acute/drug therapy , Antibodies, Monoclonal, Humanized , Cytarabine/administration & dosage , Drug Administration Schedule , Female , Gemtuzumab , Granulocyte Colony-Stimulating Factor/administration & dosage , Humans , Male , Middle Aged , Mitoxantrone/administration & dosage , Recurrence , Remission Induction , Vidarabine/administration & dosage , Vidarabine/analogs & derivativesABSTRACT
A 75-year-old man was admitted to our hospital in October, 2005 for examination of pre-diagnosed pancytopenia. His bone marrow showed myeloid dysplasia, and 30.4% of the nucleated cells were blasts. Our diagnosis was acute myelogenous leukemia with multilineage myelodysplasia (AML with MLD; WHO classification). A direct Coombs test proved positive, and the platelet-associated IgG (PA-IgG) level was elevated. After treatment with CAG (Ara-C + ACR + G-CSF), complete remission was obtained, showing negative on the direct Coombs test with PA-IgG levels returned to normal. The patient subsequently relapsed, testing positive on the direct Coombs test and experiencing a re-elevation of PA-IgG levels. We report here a first case of AML with MLD, direct Coombs test and PA-IgG assay.
Subject(s)
Blood Platelets/immunology , Coombs Test , Immunoglobulin G/blood , Leukemia, Myeloid, Acute/complications , Leukemia, Myeloid, Acute/diagnosis , Myelodysplastic Syndromes/complications , Myelodysplastic Syndromes/diagnosis , Aclarubicin/administration & dosage , Aged , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cytarabine/administration & dosage , Granulocyte Colony-Stimulating Factor/administration & dosage , Humans , Leukemia, Myeloid, Acute/blood , Leukemia, Myeloid, Acute/drug therapy , Male , Myelodysplastic Syndromes/blood , Myelodysplastic Syndromes/drug therapy , Pancytopenia/etiology , Prednisolone/administration & dosage , Treatment OutcomeABSTRACT
A 49-year-old man was admitted with high-grade fever, night sweating and cervical lymphadenopathy in September 2005. On examination, both neutrophilia and thrombocytosis were noted in the peripheral blood, a bone marrow examination revealed marked both myeloid and megakaryocytic hyperplasia. The sera obtained at initial presentation showed an elevated levels of granulocyte-colony stimulating factor (G-CSF) and interleukin-6 (IL-6). A pathologic diagnosis of T-cell rich B-cell lymphoma was made based on an inguinal lymph node biopsy. Following treatment with CHOP accompanied by rituximab (R-CHOP), both the neutrophilia and thrombocytosis subsided after 3 courses of R-CHOP, resulting in a complete remission after 4 courses of chemotherapy. Neutrophilia, thrombocytosis and T-cell rich B-cell lymphoma in this patient were considerably ameliorated with chemotherapy. We report here a patient with T-cell rich B-cell lymphoma associated with both neutrophilia and thrombocytosis, suggesting that the lymphoma triggered both myeloid and megakaryocytic hyperplasia.
