“…The abnormal cell population (60% in BM) was positive for CD45dim, CD34, HLADr, CD33, CD117, CD13 and CD11c. This cell population was negative for cyCD3, cyCD79a, CD14, CD64, CD32, CD7, CD19, CD10, and CD5.
- The aCGH analysis revealed different genomic imbalances: deletion on 17q21.3; duplication of 3q26.1q29; and trisomy # 6).26 June −02 July 2016 - (3 + 7) protocol: (Daunorubicin 60 mg/m 2 for 3 days and Cytarabine 200 mg/m 2 for 7 days) | 10 Jul 2016 | Peripheral blood (PB) showed cytopenia (WBC 0.4 × 10 9 /l), anemia (Hgb 9.5 g/dl); thrombocytopenia (Plt 12 × 10 9 /l). Serum creatinine value was 19.8 umol/l (normal 45–120) and serum total bilirubin value was 22.2 (normal value 2–21 umol/l), serum Ca + 2 value 2 (2.15–2.55 mmol/l), serum Na + value 132.3 (135–148 mmol/l). -BM smear showed almost 7% of blats. | – | – |
26 Jul 2016 | -Complete remission (CR) PB showed: WBC (6.1 × 10 9 /l), Hgb (11.7 g/dl); Plt (303 × 10 9 /l). -BM smear showed almost 5% of blats | 46,XX [19]/HeH [2] | 11 Aug-17 Aug 2017 Re-Induction: ICE cytrabin 200 mg/d Day1 ➔Day7 etobside 100 mg/d Day1➔Day5 idarubicin 20 mg/d Day1 ➔Day3 |
25 Sep 2016 | -Blurred vision in the right eye (retinal detachment sensory serous). -CR -PB showed: WBC (7.4 × 10 9 /l), Hgb (11.6 g/dl); Plt (183 × 10 9 /l). -BM smear showed almost 4% of blats | 46,XX [14] | 26 Sep-28 Sep 2017 Consolidation1 - HAM Cytrabin 3G/m 2 /d Day1➔Day3 Methoxantron 20 mg/d D1,D2 |
15 Nov 2016 | Relapse. -Secondary treatment event: mass under vascular arch with splint edema of optical nerve of the right eye which causes to sever decrease of vision in the right eye. -BM smear showed almost 20–30% of blats. -Cerebrospinal fluid (CSF) was negative. PB showed: WBC (5.6 × 10 9 /l, with 98.5 of neutrophils), Hgb (11.6 g/dl); thrombocytopenia [Plt (70 × 10 9 /l)]. -Serum creatinine value was 39 umol/l (normal 45–120) and serum Ca + 2 value was 1.94 (2.15–2.55 mmol/l). -CT scan of brain was normal. | – | 17 Nov-19 Nov 2017 Consolidation2 - HAM Cytrabin 3G/d Day1➔Day3 Methoxantron 20 mg/d D1,D2 |
30 Nov 2016 | PB showed: Cytopenia [WBC (0.1 × 10 9 /l)], anemia [Hgb (8.4 g/dl)]; thrombocytopenia [Plt (20 × 10 9 /l)]. Serum creatinine value was 33 umol/l (normal 45–120), serum serum K + value 2.89 (3.5–5.2 mmol/l), and serum Na + value 134.6 (135–148 mmol/l). | – | The mass behind the retina of the right eye was still present |
03 Jan 2017 | -Disappeared the previous Mass behind retina. -Relapse. PB showed: WBC (7.5 × 10 9 /l, with 77.7 of neutrophils), Hgb (12 g/dl); Plt (178 × 10 9 /l). -BM smear showed almost 15% of blats | - Post to chemotherapy treatment GTG-banding cytogenetics revealed a karyotype 92,XXXX [4]/62,XX,+ 1,+ 4,+ 5,+ 5,+ 6, + 6, + 11, + 15, + 16, + 17, + 19, + 19, + 20, + 20,+ 21, + 22 [2]/46,XX [15]. FCM analysis of BM specimen post to chemotherapy treatment characterized this case as AML-M6 according to WHO classifications. |
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