Friday 30 September 2016

Life-threatening Capillary Leak Syndrome in an Adult with Refractory Acute Myeloid Leukemia during Allogeneic Transplantation

A 27-year-old male was first admitted to our hospital in August 2014 with complaints of chills and fever. He exhibited obvious pain and swelling of gastrocnemius and activity abstacle. Peripheral blood counts revealed white cell counts of 29.9 × 109/L, hemoglobin lever of 89g/L, platelet counts of 179 × 109/L.

Allogeneic Transplantation
Bone marrow was hypercellular exhibiting infiltration with 30% blast cells comprising myeloblasts and promonocytes. Immunophenotype analysis showed 54% abnormal cells which were positive for CD13, HLA-DR, CD11b, CD11c, CD33, CD14, CD64 and CD15, and weakly positive for CD34 and MPO. The overall findings were consistent with acute myeloid leukemia.

G-banding revealed 46, XY. Moreover, genetic testing revealed positive for dupMLL fusion. He did not respond to “HA”(HHT 4 mg/d × 7d, Ara-c 0.2 g/d × 7d) and subsequent “IA” (IDA 30 mg d1, 20 mg d2-3, Ara-c 0.2 g/d × 7d) induction chemotherapy.Salvage therapy consisted of DAC (decitabine) (20 mg/m2/d × 5d), Ara-c (cytarabine) (10 mg/m2/d × 2d) and Ara-c (10 mg/m2 every 12 h × 3d) was planned.

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