Abstract
The occurrence of acute myeloid leukemia (AML) within six months from a diagnosis of breast cancer (BC) is rarely reported in the literature, and it is associated with a poor prognosis. We report herein the case of a 40-year-old woman referred to our centre affected by BC and simultaneous AML. The patient proved refractory to first line therapy and achieved complete remission (CR) with a clofarabine-based regimen followed by allogeneic stem cell transplantation (ASCT). Both during salvage chemotherapy and after ASCT, the patient presented severe infectious complications ( acute cholecistytis and Nocardia pneumonia, respectively) treated with surgery, and currently she is alive in CR for both diseases after 29 months of follow-up. The case highlights the importance of a diagnostic assessment of any unexplained cytopenia in association with solid neoplasia under treatment, underlining the feasibility and priority of a timely treatment of the haematological neoplasm in order to achieve long-term survival.
Highlights
Academic Editor: Yusuke Shiozawa e occurrence of acute myeloid leukemia (AML) within six months from a diagnosis of breast cancer (BC) is rarely reported in the literature, and it is associated with a poor prognosis
We report the case of a 40-year-old woman referred to our centre affected by BC and simultaneous AML. e patient proved refractory to first line therapy and achieved complete remission (CR) with a clofarabine-based regimen followed by allogeneic stem cell transplantation (ASCT)
Both during salvage chemotherapy and after ASCT, the patient presented severe infectious complications treated with surgery, and currently she is alive in CR for both diseases after 29 months of follow-up. e case highlights the importance of a diagnostic assessment of any unexplained cytopenia in association with solid neoplasia under treatment, underlining the feasibility and priority of a timely treatment of the haematological neoplasm in order to achieve longterm survival
Summary
1.0 × 109/L), not further investigated, with mild anemia (hemoglobin 11.6 g/dl) and normal platelets count (168 × 109/L). On day +13 from chemotherapy, the patient was pancytopenic (hemoglobin 8.5 g/dl, white blood cells 0.750 × 109/L, neutrophils 0.2 × 109/L, and platelets 20 × 109/L) and presented a septic shock, associated with acute abdominal pain with positive Murphy sign and positive blood cultures for Escherichia coli, Staphylococcus haemolyticus, and Candida glabrata. She received antibiotic and antifungal treatment (meropenem, tigecycline, and caspofungin) and supportive care with fluids and inotropic agents. She is in good general conditions with an excellent quality of life
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