Treatment of acute monocytic leukemia after combined en-bloc liver and pancreas transplantation

Abstract

Objective To investigate the clinical characteristics, diagnosis and treatment of acute monocytic leukemia after combined en-bloc liver and pancreas transplantation. Methods Clinical data of one patient(male, 62 years), diagnosed as acute monocytic leukemia after combined en-bloc liver and pancreas transplantation in Department of Hematology of the Third Affiliated Hospital of Sun Yat-sen University on October 2011 was analyzed retrospectively. Local ethical committee approval had been received and that the informed consent of the participating subject was obtained. Blood routine, bone marrow morphological examination, karyotype and fusion gene detection result were analyzed. Results The patient had no specific clinical manifestation except for recurrent hemorrhagic spot and lung infection after combined en-bloc liver and pancreas transplantation. Pancytopenia was found by blood routine examination 3 months after operation. The diagnosis of acute monocytic leukemia was confirmed by bone marrow morphological examination, karyotype analysis and fusion gene detection. High-dose chemotherapy was given to the patient, but no complete remission was achieved. The patient died of severe infection. Conclusions Acute monocytic leukemia is a rare complication after combined en-bloc liver and pancreas transplantation. There is no specific clinical manifestation. Laboratory examination is the main method of diagnosis. The efficacy of chemotherapy is poor and the mortality is high. Key words: Liver transplantation; Leukemia, monocytic, acute; Diagnosis; Chemotherapy