RESUMEN
Chloroma or granulocytic sarcomas (GSs) are solid tumors originating from myeloid precursors. Most frequently they occur in acute myeloid leukemia (AML), myeloproliferative disorder, and myelodysplasia. It may involve any organ system, but mostly it affects the bone and soft tissue of the head and neck. Granulocytic sarcoma resulting in spinal cord compression is rare. The association between t(8;21), and GS has been reported. In spite of the fact that t(8;21) is considered to be associated with good prognosis, patients with GS and spinal cord compression had less favorable prognosis than other AML patients with t(8;21). Radiotherapy, chemotherapy, and surgical decompression are the accepted methods of therapy. However, aggressive therapy such as transplantation may be warranted early in the therapeutic strategy. Pregnancy associated with AML is rare. In our research, only one case of pregnancy with GS and AML has been previously reported. We are reporting a pregnant female diagnosed with AML/M2 with t(8;21) at the first trimester, who relapsed with GS, and cord compression at full term. She had a normal baby, and achieved second remission post-chemotherapy. Unfortunately, shortly after this she had a relapse, and died.
Asunto(s)
Cromosomas Humanos Par 21 , Cromosomas Humanos Par 8 , Leucemia Mieloide Aguda/complicaciones , Complicaciones Neoplásicas del Embarazo/patología , Sarcoma Mieloide/patología , Translocación Genética , Cordón Umbilical/patología , Adulto , Femenino , Humanos , Leucemia Mieloide Aguda/genética , Imagen por Resonancia Magnética , Embarazo , Complicaciones Neoplásicas del Embarazo/genética , Sarcoma Mieloide/complicaciones , Sarcoma Mieloide/genéticaRESUMEN
Imatinib is one of the most recent medications used for the treatment of chronic myeloid leukemia (CML) and gastrointestinal stromal tumor (GIST). It is an orally administered protein-tyrosine kinase inhibitor, an enzyme which is produced by BCR-ABL fusion which results from translocation of 9:22 chromosome (Philadelphia chromosome). Imatinib blocks proliferation and induces apoptosis of BCR-ABL-expression in CML. Many side effects produced by imatinib have been documented but its induction of hepatotoxcity has been rarely reported. Only a few cases so far have been reported in the literature and almost all were in females. We describe another case of hepatotoxicity due to imatinib in a 17-year old female with clinical, laboratory and histopathological changes. The case described here suggests that imatinib may also induce immune hepatitis, in some patients.