Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023467 (acute myeloid leukemia)
 35,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cyclosporine (CSP) is the most frequently used immunosuppressive agent for prevention of graft versus host disease (GVHD) in allogeneic bone marrow transplantation (BMT). Some adverse effects such as hepatic and renal toxicity have been frequently encountered, but central nervous system (CNS) toxicity caused by CSP is rare. We report an adult male patient with acute myeloid leukemia who developed CSP-induced encephalopathy under treatment for allogeneic BMT from an unrelated donor. Methotrexate and CSP were used for GVHD prophylaxis. Leukocyte and platelet engraftment were successfully achieved on days 21 and 24 after BMT, respectively. Abrupt onset of mental confusion and disorientation occurred on day 25, followed by a generalized tonic clonic seizure and consciousness disturbance. The whole blood CSP level was 160.65 ng/mL. Magnetic resonance (MR) imaging revealed high signal intensities in the bilateral occipital lobes with predominant involvement of the cortical areas. The patient recovered from the CNS toxicity, but with slight memory impairment, 6 days after CSP was discontinued. When patients receiving CSP treatment for allogeneic BMT develop mental confusion, consciousness disturbance, or seizure, CSP-induced CNS toxicity should be taken into consideration.
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PMID:Cyclosporine-induced encephalopathy in a patient with relapsed acute myeloid leukemia treated with unrelated allogeneic bone marrow transplantation. 1082 Sep 59

Lesions of the central nervous system (CNS) in acute myeloid leukemia (AML) have a wide range of causes. Apart from infection, virus, fungus and bacteria have to be excluded. Other causes including involvement of leukemia, toxic encephalopathies induced by chemotherapy and radiation therapy, and vascular lesions must be diagnosed differentially for advanced treatment or follow-up. While ultimate diagnosis rests on the collection of cerebrospinal fluid, it is not enough for essential diagnosis. Imaging techniques such as head MRI are powerful tools for diagnosis of intracranial organic lesions, especially in this setting involving leukemia, progressive multifocal leukoencephalopathy (PML) by JC virus infection and treatment-related disseminated necrotizing leukoencephalopathy. A 50-year-old man with AML, who relapsed three times,progressed to an acute consciousness disturbance and was complicated with multiple CNS lesions. He presented with a vesicle formation on his skin, which was pathologically diagnosed as virus infection 1 week after CNS lesions appeared. He was considered to have systemic herpes infection. In this case, considered judgment with multiple approaches would be needed for diagnosis in some cases of AML with the CNS infiltration shadow.
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PMID:[A case of relapsed acute myeloid leukemia with brain white matter lesions]. 1743 58

We report the case of a 75-year-old man with acute myeloid leukemia who developed hyponatremia after linezolid administration. Because induction therapy did not achieve complete remission for this man, we initiated re-induction therapy with enocitabin and daunomycin. Seven days after chemotherapy, the patient experienced a catheter-related blood stream infection (CRBSI) due to methicilin resistant staphylococcus aureus (MRSA). When treatment with albekacin and fosfomycin was in effective, linezolid was administrated intravenously and he became afebrile. On day 8 after linezolid administration, however, he reported general fatigue and slight consciousness disturbance. His serum sodium concentration was 119 mEq/L and his urinary sodium excretion rose to 143 mEq/day, although intravenous sodium intake was 98 mEq/day. Because of the sufficiency of urine volume and weight loss, we surmise that inappropriate ADH secretion (SIADH) syndrome was unlikely. We diagnosed renal salt wasting syndrome (RSWS) based on calculation of the amount of sodium intake and the amount of sodium excreted from the kidneys. After linezolid was discontinued and aggressive treatment with sodium supplement begun, his consciousness cleared as his low serum sodium level rose. This is, to the best of our knowledge, the first case reported on the development of RSWS after linezolid treatment. Although the process remains unclear, our case suggests that linezolid may induce RSWS after intensive chemotherapy.
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PMID:[Marked hyponatremia with consciousness disturbance probably caused by linezolid in a patient with acute myeloid leukemia]. 1830 78

A 66year-old man with sustained fever was diagnosed as having acute myeloid leukemia with multilineage dysplasia. Induction therapy with etoposide and AraC was initiated, but was ineffective. Although fever had persisted for more than a few days, there was no evidence of any infection on radiological examination or culture studies. The patient was disorientated and demonstrated personality change. After a severe convulsive seizure, the patient died. Autopsy findings showed that the leukemic cells had permeated the Virchow Robin space, but without a mass lesion in the cerebral parenchyma. He was diagnosed as having had central nervous system leukemia (CNSL) that provoked sustained fever, consciousness disturbance and convulsive seizure. These findings suggested that the Virchow Robin space plays a particular role in the development of CNSL. Even with repeated cerebrospinal fluid examinations and radiological tests, we were unable to correctly diagnose CNSL before death, which may indicate the intractability of diagnosing CNSL spread along the Virchow Robin space. This case provides useful information about the pathophysiology and diagnosis of CNSL.
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PMID:[Acute myeloid leukemia invasion of the central nervous system, detected only along the Virchow Robin space]. 1857 12

Toxoplasmic encephalitis is a rare complication in patients with hematological malignancies. It is infrequently reported in patients undergoing allogeneic hematopoietic stem cell transplantation, much less in patients after conventional chemotherapy. A 75-year old female with acute myelogenous leukemia had an episode of aphasia, right homonymous hemianopsia, and consciousness disturbance 122 days after consolidation chemotherapy. Multiple enhancing space occupying lesions involving the left occipital lobe were seen on magnetic resonance imaging (MRI). HIV antibody was negative. Based on radiological findings, clinical presentation and positive Toxoplasma gondii serostatus, sulfadoxine and pyrimethamine were added. A rapid improvement was observed thereafter. Heightened awareness of the occurrence of toxoplasmic encephalitis, even in non-HIV patients, is needed for a better outcome.
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PMID:[Toxoplasmic encephalitis in a case of acute myelogenous leukemia after conventional consolidation chemotherapy]. 2260 81

A 17-year-old woman was urgently transported to our hospital due to consciousness disturbance. A blood examination revealed intracerebral hemorrhage, WBC 233,800/l, blasts 93%, and disseminated intravascular coagulation. The results of bone-marrow aspiration indicated acute myeloid leukemia (M2 in FAB classification) with t (7;11) (p15;p15) and the resulting chimeric gene NUP98-HOXA9 and with FLT3-ITD. Following hematoma evacuation, induction therapy was initiated and the leukocytes in the cerebrospinal fluid observed in the spinal drainage were monitored. Because they increased on days 5 and 9 after the completion of induction therapy, intrathecal chemotherapy (IT) was performed; this finally contributed to controlling AML in the central nervous system (CNS), together with the restoration of normal hematopoiesis. Subsequently, after complete molecular remission with consolidation therapies containing high-dose cytarabine, a bone-marrow transplantation with a myeloablative regimen was conducted from a 1-allele mismatched sibling donor. Finally, the patient was discharged without major sequela on day 228 after the first visit. The management of CNS disease in AML with intracerebral hemorrhage remains unclear. Our case suggests that IT at the appropriate time based on the monitored number of cerebrospinal fluid leukocytes could be useful in controlling AML in the CNS after intracerebral hemorrhage.
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PMID:[Significance of monitoring cerebrospinal fluid leukocyte counts in managing central nervous system disease of acute myeloid leukemia in patients presenting with intracerebral hemorrhage upon initial examination]. 3062 92