Sudden cardiac death as the presentation of acute myeloid leukaemia

Borg, Reuben; Said, Ian; Taylor, Mark

doi:10.1111/bjh.12056

Cited by 3 publications

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“…To our knowledge, this finding has been described in chronic haematopoietic neoplasia (lymphoma and chronic leukaemia), but not in AL. Similarly, diffuse and severe heart infiltration is rarely reported in human AL and when present, it is mostly of lymphoid lineage and can induce acute cardiac failure or sudden death . In the present case, cardiac infiltration was not associated with clinically apparent cardiac signs; moreover, the cardiac troponin I concentration, a sensitive and specific marker of myocardial injury, was normal.…”

Section: Discussionsupporting

confidence: 46%

“…Similarly, diffuse and severe heart infiltration is rarely reported in human AL and when present, it is mostly of lymphoid lineage 13,14 and can induce acute cardiac failure or sudden death. 15 In the present case, cardiac infiltration was not associated with clinically apparent cardiac signs; moreover, the cardiac troponin I concentration, a sensitive and specific marker of myocardial injury, 16,17 was normal. These findings are suggestive of silent infiltration of the myocardium with absence of cardiomyocyte damage.…”

Section: Discussionmentioning

confidence: 39%

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Acute undifferentiated leukaemia in a dog

et al. 2014

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Background Acute undifferentiated leukaemia (AUL) is considered a separate entity in the context of acute leukaemias. AUL is extremely rare in both humans and dogs, has a rapid clinical course and does not respond to treatment. It is characterised by the presence of blast cells within the bone marrow and/or peripheral blood at levels ≥20% and even up to 100% of all nucleated cells. Blast cells are unable to be differentiated on morphological, cytochemical and phenotypic criteria into myeloid or lymphoid lineages because of their immaturity and/or atypia.

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Section: Discussionsupporting

confidence: 46%

Section: Discussionmentioning

confidence: 39%

Acute undifferentiated leukaemia in a dog

et al. 2014

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Death due to unsuspected acute myeloid leukaemia: an unusual forensic diagnosis

Krebs-Drouot

Karpathiou

Scolan

et al. 2022

Forensic Sci Med Pathol

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Venetoclax plus Azacitidine as the Induction Therapy for Cardiac Myeloid Sarcoma - A Case Report with Review of Literature

Lin

et al. 2023

Preprint

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Background Cardiac myeloid sarcoma is a rare extramedullary tumor of acute myeloid leukemia, and its optimal treatment strategy has not been established such as avoiding conventional anthracycline-containing induction chemotherapy because of unwanted cardiotoxicity. Recently, venetoclax combined with azacitidine was approved for newly diagnosed acute myeloid leukemia patients who are not unsuitable for intensive chemotherapy. To the best of our knowledge, there have been no reported cases of cardiac myeloid sarcoma treated with this combination regimen.Case presentation A 63-year-old man presented with progressive dyspnea on exertion. Echocardiography showed a massive pericardial effusion. Computed tomography of the chest revealed an infiltrative mass at the right atrioventricular groove with thickened epicardium and pericardium, and multifocal lymphadenopathy. Initially, he was suspected to have IgG4-related disease and Erdheim-Chester disease, based on elevated serum lgG4 levels and histopathological findings of axillary lymph node and endomyocardial biopsy. Despite treatment, his left ventricular systolic dysfunction rapidly deteriorated. Peripheral blood blasts were unexpectedly observed later, and subsequent bone marrow examination confirmed acute myeloid leukemia. Retrospective review of the endomyocardial biopsy specimen verified the diagnosis of cardiac myeloid sarcoma. To minimize the risk of chemotherapy-induced cardiotoxicity, we chose venetoclax plus azacitidine as induction therapy, followed by high-dose cytarabine consolidation and allogeneic hematopoietic stem cell transplant, which lead to a complete remission.Conclusions Although extremely rare, cardiac myeloid sarcoma can cause fulminant heart failure and should be included in the differential diagnosis of cardiac tumors, even without a prior history of hematologic disorders. Our report demonstrates for the first time that the combination of venetoclax and azacitidine is an effective and safe induction therapy for cardiac myeloid sarcoma.

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Sudden cardiac death as the presentation of acute myeloid leukaemia

Cited by 3 publications

References 0 publications

Acute undifferentiated leukaemia in a dog

Acute undifferentiated leukaemia in a dog

Death due to unsuspected acute myeloid leukaemia: an unusual forensic diagnosis

Venetoclax plus Azacitidine as the Induction Therapy for Cardiac Myeloid Sarcoma - A Case Report with Review of Literature

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