Acute myelogenous leukemia associated with extreme symptomatic thrombocytosis and chromosome 3q translocation: case report and review of literature.
Acute leukemias with thrombocytosis have been recently linked with structural abnormalities of the short arm of chromosome 3. A 46-year-old man with a 2-month history of recurrent transient ischemic attacks and abdominal pain developed an ischemic left foot and a gangrenous toe as his initial symptoms. Platelet count was 3.5 x 10(6)/microL, and despite plateletpheresis, the patient required left-leg amputation. Pathologic examination was remarkable for arterial thrombosis in the absence of atherosclerotic lesions. A diagnosis of acute myeloid leukemia with a novel translocation between chromosomes 3q21, 16, and 7 was made. Induction therapy was unsuccessful, and the patient died of overwhelming sepsis within 5 weeks of diagnosis. The striking features of this case were extreme symptomatic thrombocytosis, peripheral gangrene without atherosclerosis, and a novel three-way chromosomal translocation involving chromosome 3q21.
Chang
Victor T
VT
Section of Hematology/Oncology, VA Health Care System of New Jersey, and Department of Medicine, UMDNJ/NJMS, Newark, New Jersey 07018, USA. victor.chang@med.va.gov
Aviv
Hana
H
Howard
Leslie M
LM
Padberg
Frank
F
D000208:Acute Disease; D000671:Amputation, Surgical; D019457:Chromosome Breakage; D002893:Chromosomes, Human, Pair 3 / Q000235:genetics / Q000648:ultrastructure*; D017809:Fatal Outcome; D005434:Flow Cytometry; D005734:Gangrene / Q000209:etiology / Q000601:surgery; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007511:Ischemia / Q000209:etiology; D002546:Ischemic Attack, Transient / Q000209:etiology; D007951:Leukemia, Myeloid / Q000150:complications* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects; D013577:Syndrome; D013922:Thrombocytosis / Q000209:etiology*; D013927:Thrombosis / Q000209:etiology*; D014034:Toes / Q000098:blood supply; D014178:Translocation, Genetic