Abstract
Abstract A female patient (N.H.) 70-years-old, married and having two children was admitted to the oncology department El Agouza police Hospital, Egypt on July 2018, She was diagnosed with Relapsed Acute Myeloid Leukemia (AML), with the following clinical presentation; fever, shortness of breath, frequent coughing, night sweats, joint pain and bruising, her ultrasound examination revealed mild splenomegaly, moreover, there was an evidence of endocrinology diagnosis with Type II Diabetes and Grade III Obesity. Concerning the medication history, she had started Decitabine (Dacogen®) 3 months ago to be continued for another 3 months to follow her chemotherapeutic plan, also was on hydroxychloroquine and leflunomide (Avara®) past year for her rheumatoid arthritis, her laboratory results showed very low platelet count 50,000/mm cub, but normal complement C3 and C4 levels , 90 mg/dl and 30 mg/dl respectively. It was concluded that the use of Hydroxychloroquine in patients diagnosed with acute myeloid leukemia also suffering rheumatoid arthritis, may decrease their platelet count and increase the risk of bleeding, therefore, it is recommended to prescribe an alternative disease-modifying anti-rheumatic drugs (DMARDs).
Highlights
Acute Myeloid leukemia (AML) is a type of cancer starting from the myeloid line of blood cells, where tumor cells within the bone marrow grow rapidly interfering with the assembly of normal blood cells [1]
Since Acute Myeloid Leukemia (AML) progresses rapidly, it's typically fatal within weeks or months if left untreated, previous chemotherapy exposure and radiation are risk factors for developing it, where, the danger is highest about three to 5 years after chemotherapy, specific genetic abnormalities as GATA2 deficiency-induced Acute Myeloid leukemia, it could first appear in children or adults [3]
Acute Myeloid leukemia affected about 1 million case, resulted in 147,000 deaths globally in 2015, it most typically occurs in older adults, men are more susceptible than women
Summary
Acute Myeloid leukemia (AML) is a type of cancer starting from the myeloid line of blood cells, where tumor cells within the bone marrow grow rapidly interfering with the assembly of normal blood cells [1]. Since AML progresses rapidly, it's typically fatal within weeks or months if left untreated, previous chemotherapy exposure and radiation are risk factors for developing it, where, the danger is highest about three to 5 years after chemotherapy, specific genetic abnormalities as GATA2 deficiency-induced Acute Myeloid leukemia, it could first appear in children or adults [3]. This specific genetic mutations within the cancer cells may guide therapy and determine how long that person is likely to survive [4].
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