Clinical Management of Atypical Cases of Acute Myeloid Leukemia Associated with Polyuria-Polydipsia Syndrome

Authors

  • Diana-Andreea Ciortea ”Dunarea de Jos” University of Galati
  • Eva Maria Elkan ”Dunarea de Jos” University of Galati
  • Alexandra Mihaela Doagă ”Dunarea de Jos” University of Galati
  • Madălina Nicoleta Matei ”Dunarea de Jos” University of Galati
  • Aurel Nechita ”Dunarea de Jos” University of Galati

Keywords:

myeloid; laeukemia; polyuria; polydipsia; management

Abstract

Objectives Acute leukaemia is the most common type of cancer in the paediatric population and the myeloid form represents only 15 percent. In this paper we aim to emphasize the management difficulties of this pathology in pediatric patients. Prior Work Studies addressing the costs and burden of acute myeloid laeukemia (AML) in children are sparse in the international literature, due to the low incidence rate, high mortality and some rare clinical aspects, such as polyuria-polydipsia syndrome. Hematologic tests usually can be relevant. Less common complications, that may require urgent intervention, include central nervous system involvement, hyperleukocytosis, and tumor lysis syndrome. There for, the total amount of resources used for the management of these patients represent an important burden for the medical systems all over the world. Approach In the current paper we present two clinical cases of paediatric patients diagnosed with AML, associated with leukostasis syndrome, neurologic impairment. ResultsIn both cases it was more cost effective to use a rational corroboration of basic diagnostic tools adapted to each clinical form. Due to the fulminant evolution of these patients towards a negative outcome, we focused the most effort and resources on intensive care treatment methods to prolong the survival rate of our patients. Implications Such atypical cases may represent a strenuous management challenge for pediatric medical professionals and financial health system responsible. Value Clinical presenting aspects described in these two cases are extremely rare in pediatrics and represent an effective way to improve medical practice and share a local clinical management experience and resources usage.

Author Biographies

Diana-Andreea Ciortea, ”Dunarea de Jos” University of Galati

Assistant professor, Faculty of Medicine and Pharmacy

Eva Maria Elkan, ”Dunarea de Jos” University of Galati

Lecturer, Faculty of Medicine and Pharmacy

Alexandra Mihaela Doagă, ”Dunarea de Jos” University of Galati

Assistant professor, Faculty of Medicine and Pharmacy

Madălina Nicoleta Matei , ”Dunarea de Jos” University of Galati

Professor, Faculty of Medicine and Pharmacy

Aurel Nechita, ”Dunarea de Jos” University of Galati

Professor, Faculty of Medicine and Pharmacy

References

1. Metayer C, Dahl G, Wiemels J, Miller M. (2016) Childhood Leukemia: A Preventable Disease. Pediatrics. 2016;138(Suppl 1):S45-S55.
2. Gamis AS, Alonzo TA, Perentesis JP, Meshinchi S, (2013) COG Acute Myeloid Leukemia Committee. Children's Oncology Group's 2013 blueprint for research: acute myeloid leukemia. Pediatr Blood Cancer. 2013 Jun;60(6):964-71.
3. Arber DA, Orazi A, et al. (2016). The 2016 revision to World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. (May 2016) 127 (20): 2391-405.
4. Mahmood, H., Abdullah, W.Z., Yong, A.C. et al. (2014) A review of AML classification: a single institution experience in a developing country. J Hematopathol 2014:7, 3–8
5. Gupta N, Pawar R, Banerjee S, et al. (2019) Spectrum and Immunophenotypic Profile of Acute Leukemia: A Tertiary Center Flow Cytometry Experience. Mediterr J Hematol Infect Dis. 2019;11(1):e2019017.
6. Gulley ML, Shea TC, Fedoriw Y. (2010) Genetic tests to evaluate prognosis and predict therapeutic response in acute myeloid leukemia. J Mol Diagn. 2010;12(1):3-16.
7. Taketani, T., Taki, T., Nakamura, T. et al. (2010). High frequencies of simultaneous FLT3-ITD, WT1 and KIT mutations in hematological malignancies with NUP98-fusion genes. Leukemia 2010:24, 1975–1977
8. Genetic Alliance; The New York-Mid-Atlantic Consortium for Genetic and Newborn Screening Services. Understanding Genetics: A New York, Mid-Atlantic Guide for Patients and Health Professionals. Washington (DC): Genetic Alliance; 2009 Jul 8. APPENDIX I, GENETIC TESTING METHODOLOGIES. Available from: https://www.ncbi.nlm.nih.gov/books/NBK115548/
9. Blum W, Bolwell BJ, Phillips G, et al. (2006) High disease burden is associated with poor outcomes for patients with acute myeloid leukemia not in remission who undergo unrelated donor cell transplantation. Biol Blood Marrow Transplant. 2006;12(1):61-67.
10. Masetti R, Vendemini F, Zama D, Biagi C, Pession A, Locatelli F. (2015) Acute myeloid leukemia in infants: biology and treatment. Front Pediatr. 2015;3:37.
11. W. Wossmann, A. Borkhardt, R. Gossen, F.J. Gobel, A. Reiter. (2002), Acute myeloid leukemia presenting with diabetes insipidus. Eur J Pediatr, 2002: 161 pp. 161-162
12. Curley, G. Kennedy, A. Haughton, A. Love, C. McCarthy, A. Boyd. (2010), Acute myeloid leukemia, the 3q21q26 syndrome and diabetes insipidus: a case presentation. Asia Pac J Clin Oncol, (6/2010), pp. 77-79
13. A. Harb, W. Tan, G.E. Wilding, M. Batiwalla, S. Sait, E. Wang, et al. (2009), Acute myeloid leukemia and diabetes insipidus with monossomy 7. Cancer Genet Cytogenet, 190 (2009), pp. 97-100
14. Portela M, et al. (2012) Diabetes insípida como forma de presentación atípica de leucemia mieloide aguda. Endocrinol Nutr. 2012;59(8):516–19
15. Giammarco S, Chiusolo P, Piccirillo N, et al. (2017) Hyperleukocytosis and leukostasis: management of a medical emergency. Expert Rev Hematol. 2017;10(2):147-154.
16. Gong J, Wu B, Guo T, Zhou S, He B, Peng X. (2014) Hyperleukocytosis: A report of five cases and review of the literature. Oncol Lett. 2014;8(4):1825-1827.
17. Belay Y, Yirdaw K, Enawgaw B. (2017) Tumor Lysis Syndrome in Patients with Hematological Malignancies. J Oncol. 2017:9684909.
18. Barbui T, Falanga A. (2001) Disseminated intravascular coagulation in acute leukemia. Semin Thromb Hemost. 2001;27(6):593-604.
19. Hatzl S, Uhl B, Hinterramskogler M, et al. (2018) Acute myeloid leukemia with severe coagulation disorder and concomitant central nervous system bleeding - a clinical diagnostic case report. EJIFCC. 2018;29(2):146-151.

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Published

2021-12-27

How to Cite

Ciortea, D.-A., Elkan, E. M., Doagă, A. M., Matei , M. N., & Nechita, A. (2021). Clinical Management of Atypical Cases of Acute Myeloid Leukemia Associated with Polyuria-Polydipsia Syndrome : Array. Acta Universitatis Danubius. Œconomica, 17(6). Retrieved from https://dj.univ-danubius.ro/index.php/AUDOE/article/view/1486

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Entrepreneurial Perspectives