A case of acute promyelocytic leukemia concomitant with plasma cell myeloma

Simultaneous occurrence of multiple myeloma and acute myeloid leukemia: Case report and literature review

Multiple myeloma (MM) and acute myeloid leukemia (AML) are malignant clonal diseases of cells in different lineages. It remains very rare to have both diseases at first diagnosis. Only 24 cases of this situation were reported from 1971 to 2021, and poor prognosis in most cases. However, here we describe a case of de novo MM and AML occurring simultaneously in a 65-year-old woman. We have successfully used individualized treatment regimens to allow the patient to survive 1.5 years to date, which has exceeded 80 % of statistical cases.

Kidney Biopsy Un-masquerading Plasma Cell Leukemia Diagnosed as Acute Myeloid Leukemia: An Unusual Clinical Experience

Plasma cell leukemia (PCL) is a rare aggressive variant of plasma cell myeloma. The differential diagnosis of PCL includes multiple myeloma (MM), other leukemias, and lymphomas with abnormal cells circulating in the peripheral blood. In addition, infectious or autoimmune diseases can cause reactive polyclonal plasmacytosis, which could confuse us with PCL occasionally. Sometimes, blastoid morphology can cause confusion in diagnosis, and immunohistochemistry is needed to differentiate PCL from other forms of leukemias and lymphomas. Here, we present a rare case of PCL diagnosed as acute myeloid leukemia (AML) with kidney biopsy establishing the correct diagnosis.

Double trouble: A case of synchronous presentation of acute myeloid leukaemia and multiple myeloma

Malignancies following successful chemotherapy for various malignant diseases, including multiple myeloma (MM), are well known and documented. The occurrence of acute myeloid leukaemia (AML) after chemotherapy for MM with alkylating agents is well described; however, simultaneous occurrence of the two entities with no prior therapy is extremely rare. We describe a case of an elderly patient with no previous exposure to chemotherapy, who was diagnosed with both MM and AML concurrently. Very few similar cases have been described in the literature.

Myelodysplasia-related acute myeloid leukemia and acute promyelocytic leukemia: concomitant occurrence of two molecularly distinct diseases

Concurrent presentation of acute promyelocytic leukemia (APL) with other hematologic diseases in the absence of previous chemotherapy or ionizing radiotherapy treatment is very rare. We present a case of simultaneous occurrence of APL with myelodysplastic syndrome (MDS)-related acute myeloid leukemia (AML). A 43-yearold female presented with 3 month of history fatigue, night sweats, chills and pancytopenia. Bone marrow aspirate and biopsy demonstrated 20% myeloid blasts with dysplastic changes admixed with abnormal promyelocytes. Cytogenetic analysis showed tetraploidy and deletion in chromosomes 5q and 7q and polymerase chain reaction showed presence of PML/RARA mRNA transcripts, confirming the presence of concurrent APL and MDS-related AML. Induction chemotherapy with cytarabine and daunorubicin was initiated along with all-trans retinoic acid. This is the first case to be reported in the literature of concurrent occurrence of APL with MDS-related AML. Treatment with 7 + 3 regimen and ATRA was successful in inducing complete remission.

Synchronous Plasma Cell Myeloma and Acute Myeloid Leukemia in a Therapy-Naïve Patient: A Rare Occurrence

Plasma cell proliferations in patients with acute myeloid leukemia (AML) are rare, whether at presentation or during or after therapy. Interpretation requires correlation with the clinical background, drug history as well as inputs from tests for monoclonal gammopathy and end-organ damage. The major diagnostic issues stem from excluding myeloma alone with a plasmablastic morphology that mimics AML as well as reactive or polyclonal plasmacytosis occurring in a bonafide case of AML alone before rendering a rare diagnosis of true dual pathologies. We report a rare case of concurrent AML and plasma cell myeloma in a 55-year-old lady that posed a significant diagnostic challenge. The patient had significant co-morbidities complicating the clinical picture and was treatment-naïve at the time of diagnosis. Our approach to confirming the diagnosis, as well the challenges faced in flow cytometric analyses are highlighted. The pathogenesis of such dual pathologies remains unresolved, although various conjectures and theories have been propounded in literature.