July 9, 2018


Case: A 68-Year-Old Man With Newly-diagnosed AML

  • A 68-year-old man went to the emergency room with complaints of dizziness and chest pain
    • Myocardial infarction diagnosed and managed in hospital
    • During stay, CBC revealed decreased neutrophils but increased total white blood cell count
    • When stable from MI, he was referred for specialist consultation
  • Patient history and physical exam:
    • Reported fatigue, shortness of breath with minor exertion, and unexplained weight loss that have worsened over the past 2 months
    • Over the 6 months, has experienced three upper respiratory infections, often with mild fever, that were refractory to treatment, but which he attributed to being a former smoker
    • No history of cancer or cytotoxic treatment
  • Laboratory findings:
    • Absolute neutrophil count: 600 cells/µL; WBC: 85,000 cells/µL
    • Peripheral blood shows poorly differentiated myeloid cells
    • 25% blasts in peripheral blood
    • Cytogenetic abnormalities: chromosome 5 (del[5q])
  • Diagnosed with acute myeloid leukemia with myelodysplastic-related changes
  • Received Vyxeos (CTX-351) induction therapy, followed by consolidation
    • Experienced complete response and underwent HSCT