Recovery from diabetes insipidus associated with AML after a BMT conditioning regimen including busulfan.
We describe a patient who, at the onset of acute myelomonocytic leukemia, presented with marked polyuria, polydipsia and laboratory findings consistent with diabetes insipidus (DI). He was treated with vasopressin (DDAVP) with a good response and concurrently induced with daunorubicin and conventional doses of cytosine arabinoside. CR was achieved. The vasopressin requirement decreased progressively, but the patient remained DDAVP-dependent after consolidation treatment. He underwent allogeneic BMT, conditioned with busulfan and cyclophosphamide. By day 15 after BMT vasopressin was no longer required and at a follow-up of 9 months the patient has no evidence of DI. In the absence of specific findings, we think it possible that he had leukemic microinfiltration of the hypothalamic-pituitary area. The drugs used for conditioning may have eradicated CNS disease.
Pagano
L
L
Istituto di Semeiotica Medica, Università Cattolica S. Cuore, Rome, Italy.
Voso
M T
MT
Sica
S
S
Leone
G
G
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016465:Bone Marrow Purging; D016026:Bone Marrow Transplantation; D002066:Busulfan; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage; D003894:Deamino Arginine Vasopressin / Q000627:therapeutic use; D003919:Diabetes Insipidus / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D015479:Leukemia, Myelomonocytic, Acute / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D008297:Male; D012074:Remission Induction
D003561:Cytarabine; D003894:Deamino Arginine Vasopressin; D002066:Busulfan; D003630:Daunorubicin