| Title | Co-existence of acute myeloid leukemia with multilineage dysplasia and Epstein-Barr virus-associated T-cell lymphoproliferative disorder in a patient with rheumatoid arthritis. | | Author(s) | Tokuhira M, Hanzawa K, Watanabe R, Sekiguchi Y, Nemoto T, Toyozumi Y, Tamaru JI, Itoyama S, Suzuki K, Kameda H, Mori S, Kizaki M | | Source | J Hematol Oncol 2009 Jun 30; 2(1):27. | | Abstract | ABSTRACT: We here report a case of rheumatoid arthritis (RA) with acute myeloid leukemia with multilineage dysplasia (AML-MLD) and Epstein-Barr virus (EBV)-associated T-cell lymphoproliferative disorder (T-LPD). A 64-year-old healthy man suffered from arthralgia, and was ultimately diagnosed with RA based on bilateral hand X-rays showing mild swelling and destruction of the MP and PIP joints. Since non-steroidal anti-inflammatory drugs were not effective, prednisolone and bucillamine were administered. After 4 months, his pancytopenia gradually progressed, and bone marrow (BM) examination revealed the presence of AML-MLD. A chemotherapeutic drug regimen including low-dose cytarabine led to nearly complete remission, but several weeks later, high fever and dyspnea suddenly appeared. Computer tomography revealed massive plural effusion, ascites, splenomegaly and lymphoadenopathy, and the BM revealed EBV-associated T-LPD. Steroid and cyclophosphamide were administered, but the patient died from multiple organ failure with pneumonia and sepsis. An autopsy disclosed the presence of massive myeloblast cell infiltration, but not EBER, in the BM, liver, spleen, pancreas, and adrenal glands. In contrast, both myeloid blasts and EBER-positive small T-lymphocytes were detected in the lymph nodes. To the best of our knowledge, this is the first report of the simultaneous presence of AML-MLD and EBV-associated T-LPD in RA. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19566938 |
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