[Acute-onset eosinophilic leukemia associated with tumor lysis syndrome after imatinib and steroid pulse therapy].
An 83-year-old woman had been suffering from palpitations and fatigue for a month. An annual screening test revealed an increased WBC count so she was referred to our hospital. CBC showed extremely elevated WBC count (186,300/microl), in which the population of blastic eosinophils was over 90%. The eosinophils expressed CD7/13/33/34/DR, and the karyotype demonstrated 47,XX,+8. The fusion gene of FIP1-LP/PDGFRalpha in peripheral blood was negative. As plural effusion due to the underlying disease progressively worsened, she was given prednisolone and hydroxyurea, but the effect was limited. Steroid pulse therapy and imatinib (100 mg/day) were administrated. As a result, a prompt response was observed. The WBC count rapidly decreased, but tumor lysis syndrome led to acute renal failure and disseminated intravasucular coagulation appeared. Supportive therapies such as artificial dialysis and transfusions were conducted, but unfortunately she died because of alveolar hemorrhage.
Nemoto
Tomoe
T
Department of Hematology, Saitama Medical Center, Saitama Medical University.
Saito
Yuriko
Y
Tokuhira
Michihide
M
Tomikawa
Atsushi
A
Sagawa
Morihiko
M
Haba
Yuichiro
Y
Hanzawa
Kyoko
K
Sekiguchi
Yasunobu
Y
Watanabe
Reiko
R
Tamaru
Jun-ichi
J
Itoyama
Shinji
S
Mori
Shigehisa
S
Kizaki
Masahiro
M
D058186:Acute Kidney Injury / Q000209:etiology; D000369:Aged, 80 and over; D001549:Benzamides; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D004357:Drug Synergism; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D017681:Hypereosinophilic Syndrome / Q000150:complications; D000068877:Imatinib Mesylate; D015472:Leukemia, Eosinophilic, Acute / Q000150:complications* / Q000188:drug therapy*; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects*; D010879:Piperazines / Q000008:administration & dosage / Q000009:adverse effects*; D010996:Pleural Effusion / Q000209:etiology; D020551:Pulse Therapy, Drug; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects*; D015275:Tumor Lysis Syndrome / Q000209:etiology*
D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D008775:Methylprednisolone