title: [Two cases of acute myelogenous leukemia complicated with fatal gastrointestinal tract bleeding after treatment with idarubicin and cytarabine].
abstract: We describe herein two newly diagnosed patients with acute myelogenous leukemia (AML), who were treated twice with an idarubicin hydrochloride (IDR)-containing regimen as a response-orientated induction therapy. Both patients had severe gastrointestinal tract hemorrhage complications at their nadir. The two patients were as follows: a 35-year-old male, FAB-M4, and a 47-year-old female, FAB-M0. They received the same induction chemotherapy (IDR 12 mg/m2 for four days and cytarabine 100 mg/m2 for ten days). No response (NR) was obtained in either, so they underwent the same regimen again. During the period of myelosuppression, they developed severe gastrointestinal hemorrhage. One died of sepsis, and the other of acute respiratory distress syndrome without a recovery in bone marrow. The fetal gastrointestinal tract complications may have been due to severe myelosuppression and mucosal damage in these patients. Careful observation will be needed to prevent such severe complications after the treatment with IDR.
authors.affiliation: Dept. of Hematology, Jichi Medical School.
authors.forename: T
authors.initials: T
authors.lastname: Nagashima
authors.forename: T
authors.initials: T
authors.lastname: Izumi
authors.forename: K
authors.initials: K
authors.lastname: Muroi
authors.forename: A
authors.initials: A
authors.lastname: Miyasato
authors.forename: M
authors.initials: M
authors.lastname: Uchida
authors.forename: S
authors.initials: S
authors.lastname: Imagawa
authors.forename: N
authors.initials: N
authors.lastname: Komatsu
authors.forename: M
authors.initials: M
authors.lastname: Yoshida
authors.forename: K
authors.initials: K
authors.lastname: Hatake
authors.forename: Y
authors.initials: Y
authors.lastname: Miura
authors.forename: K
authors.initials: K
authors.lastname: Ozawa
mesh_terms: D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D001853:Bone Marrow / Q000187:drug effects; D017809:Fatal Outcome; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced*; D006801:Humans; D015255:Idarubicin / Q000009:adverse effects*; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
chemical_list: D000903:Antibiotics, Antineoplastic; D015255:Idarubicin