A recurrent acute myeloid leukemia with pericardial effusion after allogeneic hematopoietic stem cell transplantation

DOI Web Site 8 References
  • Sato Ken
    Department of Gastroenterology and Hematology/Clinical oncology, Internal Medicine, Steel Memorial Muroran Hospital
  • Kuroda Hiroyuki
    Department of Gastroenterology and Hematology/Clinical oncology, Internal Medicine, Steel Memorial Muroran Hospital
  • Yamauchi Natsumi
    Department of Gastroenterology and Hematology/Clinical oncology, Internal Medicine, Steel Memorial Muroran Hospital
  • Horiguchi Hiroto
    Department of Gastroenterology and Hematology/Clinical oncology, Internal Medicine, Steel Memorial Muroran Hospital
  • Yamada Michiko
    Department of Gastroenterology and Hematology/Clinical oncology, Internal Medicine, Steel Memorial Muroran Hospital
  • Fujita Miri
    Department of Pathology and Clinical Laboratory, Steel Memorial Muroran Hospital
  • Shido Mitsuo
    Department of Radiology, Muroran City General Hospital
  • Yoshida Masahiro
    Oncology and Hematology, Internal Medicine, Sapporo Medical University
  • Usami Makoto
    Oncology and Hematology, Internal Medicine, Sapporo Medical University
  • Shimoyama Saori
    Oncology and Hematology, Internal Medicine, Sapporo Medical University
  • Maeda Masahiro
    Department of Gastroenterology and Hematology/Clinical oncology, Internal Medicine, Steel Memorial Muroran Hospital

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Other Title
  • 造血細胞移植後に心嚢再発した急性骨髄性白血病

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Abstract

 This case describes a 38-year-old woman who visited her previous physician because of fever and general malaise that she had experienced since March 2014. An increased leukocyte count was observed, and the patient was subsequently referred to our department. She was diagnosed with acute myeloid leukemia (AML) and achieved complete remission with remission induction therapy given in accordance with the JALSG AML201 protocol. However, AML relapsed after remission therapy. FLAGM therapy was performed for the re-induction of remission but was ineffective. The patient was consequently pre-treated with gemtuzumab ozogamicin, and subsequently underwent peripheral blood stem cell transplantation from a related donor in October. Although a bone marrow aspiration performed on day 33 revealed that complete remission had been achieved, peripheral hemoblasts were detected on day 47. Immediately after transplantation the patient presented with heart failure which was resistant to drug treatment, indicating a refractory condition. Moreover, AML invasion was confirmed through pericardiocentesis. The patient did not wish to undergo aggressive therapy and eventually died in December. Here, we report a rare case of pericardial invasion that occurred after hematopoietic stem cell transplantation.

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