Acute Monoblastic Leukemia with t(10;11)(p12;q23) Presenting with Pulmonary Involvement: A Case Report and Literature Review
Kannadit Prayongratana MD*, Manaphol Kulpraneet MD*, Prapaporn Panichchob BSc**, Woraphot Tantisiriwat MD***
Affiliation : * Department of Medicine, Faculty of Medicine, Srinakharinwirot University, Nakhon-nayok ** Department of Pathology, Faculty of Medicine, Srinakharinwirot University, Nakhon-nayok *** Department of Preventive and Social Medicine. Faculty of Medicine, Srinakharinwirot University, Nakhon-nayok
A forty-three-year-old Thai man presented with acute fever and dyspnea for one week with bilateral patchy infiltration, pancytopenia with monoblast. Bone marrow study was consistent with acute monoblastic leukemia. Lung lesions rapidly progressed to acute respiratory failure, which required intubation. Broncho- scopy with bronchoalveolar lavage revealed monotonous monoblast infiltration. Induction chemotherapy with 7 + 3 regimen was administered to halt the progression of leukemic pulmonary infiltration. Although there was clinical improvement, the chest radiograph developed crescent formation in the right upper lung field. Invasive pulmonary aspergillosis was suspected and successfully treated with antifungal agent. After peripheral blood recovery, bone marrow evaluation was performed and complete remission was established. HLA matching was sent to prepare for hematopoietic stem cell transplantation (HSCT). The literature review showed that the appropriate treatment for the patients with t(10;11)(p12;q23) was HSCT, but there was no data concerning correlation of t(10;11)(p12;q23) and pulmonary infiltration. This may be due to the low incidence of leukemic infiltration of acute leukemia patients, which is 0.48% and 3.06% in acute myeloid leukemia and acute monoblastic leukemia, respectively.
Keywords : Acute monoblastic leukemia, Leukemic pulmonary infiltration, t(10;11)(p12;q23)
