Microfilariae with Acute Myeloid Leukemia: A Common Parasite with Uncommon Association

Abstract

Presence of microfilariae in bone marrow aspirate is an uncommon finding and its association with leukaemia has rarely been described. We present a case of young female from north India in which bancroftian microfilariae was seen in peripheral blood and bone marrow smears as an incidental finding along with 88 % myeloid blast that were positive on myeloperoxidase stain. There was no associated eosinophilia. She was started on diethylcarbazine for microfilariae, before the start of induction chemotherapy for acute myeloid leukaemia. Presently she is post induction and is doing fine.

Filarial huge splenomegaly dramatically regressed by anti-filarial medication: A rare clinical scenario

“…Uzma Zafar et al (8) reported an interesting case of low back pain and destruction of first lumbar vertebra by the microfilariae residing in the bone marrow. There were several case reports of huge splenomegaly in leukaemia patients with incidental detection of bone marrow microfilariae (9)(10)(11). Possible explanation for splenomegaly in those cases were due to leukaemia not filariasis because spleen is usually not involved in filariasis except in some experimentally infected animals although Schuurkamp GJ et al (14) showed occurrence of filarial splenomegaly in their articles.…”

Incidental association: Acute myeloid leukemia and filariasis - A case report

“…While an immunocompromised state in leukemia patients has been proposed as a predisposing factor for parasitic infections, in countries like ours where filariasis is endemic in certain areas, such findings may simply be incidental. 10 With the exception of Jain S's study in 2011, 9 most cases associated with filariasis and AML did not exhibit eosinophilia, including our own case. This begs the question of whether eosinophilia serves as a reliable indicator for diagnosing filariasis cases associated with AML.…”

Filariasis presenting with bicytopenia, progressive splenomegaly and acute renal failure: An unusual case report

“…Splenomegaly is an uncommon presentation. Where leukaemia is present, microfilariae may be an incidental and co-existing finding, 5–7 However in those cases, splenomegaly was due to the leukaemic process.…”

“…Prior reports of filariasis described on bone marrow aspirate have often been associated with underlying leukemia, 5–7 and sometimes with non-neoplastic progressive splenomegaly and anaemia, 8 resulting from inadequate management of peripheral blood eosinophilia.…”