title: A 78-year-old man with acute myeloid leukemia (AML) and acute renal failure.
abstract: METHODS
  Male, 78.
  
  
  METHODS
  Acute myeloid leukemia (AML).
  
  
  METHODS
  Dyspnea • fatigue.
  
  
  METHODS
  Idarubicin followed by cytarabine.
  
  
  METHODS
  Chemotherapy.
  
  
  METHODS
  Hematology.
  
  
  OBJECTIVE
  Unusual clinical course.
  
  
  BACKGROUND
  Renal failure is a common presentation of acute myelomonocytic and monocytic leukemia. It is usually the result of a combined glomerular and tubular dysfunction and is associated with a poor prognosis. No guidelines exist for treatment.
  
  
  METHODS
  We herein describe the case of a 78-year-old Caucasian man who presented with acute myeloid leukemia M5, leukostasis with a white count of 340 000/ml, and acute renal failure with a creatinine of 7.7/dL. The patient was initially treated with leukapheresis and 3 days of idarubicin in the setting of continuous renal replacement therapy that resulted in rapid reversal of his renal failure. He then received 7 days of continuous infusion cytarabine and went into a complete remission.
  
  
  CONCLUSIONS
  Renal failure may complicate the presentation of AML but can be reversible with treatment. Dose adjustment of the chemotherapy is not needed and the treatment can be greatly facilitated with the use of continuous renal replacement therapy, as indicated in our case report. In addition, we emphasize that organ dysfunction, even in elderly patients, is not necessarily a contraindication to aggressive treatment if it is felt to be disease-related and reversible.
authors.affiliation: Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, USA.
authors.forename: Elliot B
authors.initials: EB
authors.lastname: Tapper
authors.affiliation: Department of Hematology and Oncology, Beth Israel Deaconess Medical Center, Boston, USA.
authors.forename: Katarina
authors.initials: K
authors.lastname: Luptakova
authors.affiliation: Department of Hematology and Oncology, Beth Israel Deaconess Medical Center, Boston, USA.
authors.forename: Robin M
authors.initials: RM
authors.lastname: Joyce
authors.affiliation: Department of Hematology and Oncology, Cedars-Sinai Medical Center, Los Angeles, USA.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tzachanis
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D007937:Leukapheresis; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D008297:Male; D006435:Renal Dialysis / Q000379:methods
chemical_list: D000970:Antineoplastic Agents