Acute myelogenous leukemia associated with extreme symptomatic thrombocytosis and chromosome 3q translocation: Case report and review of literature

Chang, Victor; Aviv, Hana; Howard, Leslie; Padberg, Frank T.

doi:10.1002/ajh.10256

Cited by 17 publications

(8 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Chromosomal analysis revealed a 3q21 translocation, which is interesting because the thrombopoietin gene (TPO) is found on chromosome 3. 72 Thus platelets may play an influential role in the pathogenesis of hypercoagulability, but that role it is not yet clearly defined.…”

Section: Hyperviscositymentioning

confidence: 99%

Incidence and Pathogenesis of Thrombosis in Hematologic Malignancies

Kwaan

Vicuna²

2007

Semin Thromb Hemost

View full text Add to dashboard Cite

Recent surveys have indicated that thromboembolic complications are at least as common in hematologic malignancies, if not more frequent, than in solid tumors. The pathogenesis of thrombosis is similar to that in solid tumors, but with additional factors unique in several forms of hematologic malignancies, as seen in acute promyelocytic leukemia, myeloma, and myeloproliferative disorders. Likewise, the factors contributing to bleeding are similar to those seen in solid tumors, with the exception of a higher frequency of thrombocytopenia.

show abstract

Section: Hyperviscositymentioning

confidence: 99%

Incidence and Pathogenesis of Thrombosis in Hematologic Malignancies

Kwaan

Vicuna²

2007

Semin Thromb Hemost

View full text Add to dashboard Cite

show abstract

“…Chang et al reported a patient with acute myelogenous leukemia associated with extreme symptomatic thrombocytosis and chromosome 3q translocation [6]. Lim et al reported a patient with t(1;3)(p36;q21) and extreme thrombocytosis [7].…”

Section: Discussionmentioning

confidence: 99%

Acute mono-megakaryoblastic leukemia associated with extreme thrombocytosis and complex karyotype abnormalities

et al. 2013

Am J Case Rep

View full text Add to dashboard Cite

Patient: Female, 55Final Diagnosis: Acute leukemiaSymptoms: ThrombocytosisMedication: Idarubicin HCl (Zavedos), PfizerClinical Procedure: —Specialty: HematologyObjective:Adverse effect of drug therapyBackground:Thrombocytosis is usually seen in myeloproliferative disorders (MPD) and seldom in acute myeloid leukemias (AML). In acute megakaryoblastic leukemia, platelet counts might exceed 1000×109/L in approximately 30% of patients, while others are frequently presented by cytopenias. To our best knowledge there is no report in the literature on acute mono-megakaryoblastic leukemia, especially with extreme thrombocytosis and complex karyotype abnormalities.Case Report:We present the case of a 55-year-old woman with acute mono-megakaryoblastic leukemia with extreme thrombocytosis (greater than 2000×109/L) and complex karyotype abnormalities. The patient was first treated with anti-aggregate therapy and later the patient was put on a regimen consisting of idarubicin 10 mg/m2 daily for 3 days and 200 mg Cytosar daily for 7 days. However, a severe pancytopenia occurred at the first day after chemotherapy and the patient died from intracranial hemorrhage.Conclusions:Extreme thrombocytosis and complex karyotype abnormalities in acute mono-megakaryoblastic leukemia are associated with poor outcome.

show abstract

“…Arterial thrombi are typically seen in small and medium‐sized vessels, often in the brain, spleen, and lungs . Large arterial occlusion causing limb ischemia as a presenting symptom of AML has previously been described in only a handful of case reports . Pathologic analyses of arterial thrombi typically reveal infiltration by leukemic blasts without evidence of atherosclerosis .…”

Section: Discussionmentioning

confidence: 99%

Blue toes and a new pair of shoes—Challenges in diagnosis and treatment of acute myelogenous leukemia

et al. 2013

View full text Add to dashboard Cite

CaseA 63-year-old Caucasian female presented to the emergency department complaining of right foot pain for one day associated with blue toe discoloration for 3 weeks. She initially attributed her symptoms to trauma from a new pair of shoes but became concerned with the onset of pain. Her past medical history included hypertension and cervical cancer treated with hysterectomy 25 years ago. Her family history was noncontributory. She had a 40-pack year smoking history but quit 5 years ago. She was in good health prior to this presentation with an ECOG score of 0. Physical examination was remarkable for a weak right dorsalis pedis pulse and cyanosis of all toes on the right foot.Although a new pair of shoes is a potential explanation for developing blue toes, arterial thrombosis must be ruled out. Interestingly, the patient doesn't seem to have any reported cardiovascular risk factors or a known hypercoagulable state. It is reassuring that she is otherwise healthy and has a good performance status. We need to quickly identify the site of thrombosis and initiate prompt therapy in order to salvage the limb. It is also important to investigate the reason behind thrombus formation.Initial laboratory analysis was as follows: white cell count, 14,400/mL with 85% neutrophils, 7% lymphocytes, 7% monocytes, and 1% basophils; hemoglobin, 13.1 g/dL; mean corpuscular volume, 89 fL; platelets, 86,000/mL; international normalized ratio (INR), 1.5 [normal, 0.8-1.2]; activated partial thromboplastin time (aPTT), 29 sec [normal, 24-35 sec]; blood urea nitrogen (BUN), 18 mg/dL [normal, 8-24 mg/dL]; and creatinine, 2.0 mg/dL [normal, 0.6-1.2 mg/dL]. Peripheral smear showed granulocytosis with left shift but no blasts, 11 schistocytes, and moderate thrombocytopenia (Fig. 1a). The patient was admitted to the surgical service and empirically started on therapeutic-dose heparin drip and intravenous hydration. Arterial lower extremity Doppler showed small vessel occlusive disease without evidence of large vessel thrombosis. Abdominal vascular ultrasound and CT abdomen without contrast were unremarkable. At this time, anticoagulation was stopped. Hematology consult was called for evaluation of thrombocytopenia.Due to the patient's elevated creatinine, more sensitive imaging with contrast was not immediately performed. Although the culprit clot has not been identified, major arterial thrombosis remains high on the differential. Small vessel occlusive disease is unlikely to fully explain the patient's presentation. Her leukocytosis with left shift could represent a reactive process in response to acute inflammation. She also has evidence of coagulopathy, moderate thrombocytopenia, renal dysfunction, and presence of mild schistocytosis on peripheral smear. Differential diagnosis is broad and may include infection, vasculitis, autoimmune connective tissue disorder, and malignancy. Disseminated intravascular coagulation (DIC) with thrombocytopenia from platelet consumption and small renal infarcts is also a possibility. Thrombotic thrombocyto...

show abstract

Acute myelogenous leukemia associated with extreme symptomatic thrombocytosis and chromosome 3q translocation: Case report and review of literature

Cited by 17 publications

References 54 publications

Incidence and Pathogenesis of Thrombosis in Hematologic Malignancies

Incidence and Pathogenesis of Thrombosis in Hematologic Malignancies

Acute mono-megakaryoblastic leukemia associated with extreme thrombocytosis and complex karyotype abnormalities

Blue toes and a new pair of shoes—Challenges in diagnosis and treatment of acute myelogenous leukemia

Contact Info

Product

Resources

About