Blast crisis following surgery for strangulated ileus in a chronic myelomonocytic leukemia patient

Sasaki, Shin; Tomibayashi, Atsushi; Nakayama, Hiroshi; Watanabe, Toshiyuki

doi:10.3919/jjsa.73.885

Cited by 1 publication

(2 citation statements)

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“…In all patients with CMMoL, every effort must be made to use the least invasive procedure possible. In the present patient, our deepest concerns were to have a proper balance between invasiveness and healing, and to avoid evoking an acute blastic crisis [ 9 , 10 ]. Our most important goal was to alleviate the patient's discomfort by using a minimally invasive procedure to eliminate infection.…”

Section: Discussionmentioning

confidence: 99%

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A case of mandibular osteomyelitis in a patient with chronic myelomonocytic leukaemia

2016

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We report a case of chronic myelomonocytic leukaemia (CMMoL) in a 68-year-old man who developed osteomyelitis of the mandible. At the initial visit, he reported uncontrolled gingival bleeding, despite self-administered haemostasis. He complained of severe pain in the socket, despite potent opioid analgesia. After consultation with the internal medicine specialists, we undertook a surgical anti-inflammatory approach that included sequestrectomy with massive blood transfusion. His physical condition was ameliorated after the surgical procedure, and he was discharged from the hospital. However, 3 months later, he died because of cardiac arrest after haemorrhagic shock and cardiovascular failure because his CMMoL had developed to an acute blastic crisis. This experience demonstrates that the most important goal in such cases is to alleviate a patient's discomfort by applying minimally invasive actions to eliminate infection and improve the quality of life without causing deterioration in the CMMoL status.

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Section: Discussionmentioning

confidence: 99%

“…The median survival of patients with CMMoL is 15–20 months [ 5 , 6 , 8 ]. Several case reports have indicated that excess surgical stress causes an acute blastic crisis, which contributes to a poor outcome [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%