Acute monoblastic leukemia with t(10;11)(p12;q23) presenting with pulmonary involvement: a case report and literature review.
A forty-three-year-old Thai man presented with acute fever and dyspnea for one week with bilateral patchy infiltration, pancytopenia with monoblast. Bone marrow study was consistent with acute monoblastic leukemia. Lung lesions rapidly progressed to acute respiratory failure, which required intubation. Bronchoscopy with bronchoalveolar lavage revealed monotonous monoblast infiltration. Induction chemotherapy with 7 + 3 regimen was administered to halt the progression of leukemic pulmonary infiltration. Although there was clinical improvement, the chest radiograph developed crescent formation in the right upper lung field. Invasive pulmonary aspergillosis was suspected and successfully treated with antifungal agent. After peripheral blood recovery, bone marrow evaluation was performed and complete remission was established. HLA matching was sent to prepare for hematopoietic stem cell transplantation (HSCT). The literature review showed that the appropriate treatment for the patients with t(10;11)(p12;q23) was HSCT, but there was no data concerning correlation of t(10;11)(p12;q23) and pulmonary infiltration. This may be due to the low incidence of leukemic infiltration of acute leukemia patients, which is 0.48% and 3.06% in acute myeloid leukemia and acute monoblastic leukemia, respectively.
Department of Medicine, Faculty of Medicine, Srinakharinwirot University, Ongkharak, Nakhon-nayok, Thailand. Kannadit_swu@yahoo.com
Kannadit
K
Prayongratana
Manaphol
M
Kulpraneet
Prapaporn
P
Panichchob
Woraphot
W
Tantisiriwat
D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000473:pathology; D018893:Bronchoalveolar Lavage; D000077336:Caspofungin; D003561:Cytarabine / Q000627:therapeutic use; D054714:Echinocandins / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015255:Idarubicin / Q000627:therapeutic use; D007948:Leukemia, Monocytic, Acute / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D055666:Lipopeptides; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000628:therapy; D008297:Male; D011743:Pyrimidines / Q000627:therapeutic use; D013785:Thailand; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
D000903:Antibiotics, Antineoplastic; D000935:Antifungal Agents; D000964:Antimetabolites, Antineoplastic; D054714:Echinocandins; D055666:Lipopeptides; D011743:Pyrimidines; D014230:Triazoles; D003561:Cytarabine; D000077336:Caspofungin; D065819:Voriconazole; D015255:Idarubicin