Twin Malignancy of Acute Myeloid Leukemia and Multiple Myeloma in a Chemotherapy-Naïve Patient: A Rare Occurrence

Synchronous diagnosis of acute myeloid leukemia (AML) and multiple myeloma in chemotherapy-naïve patients is a rare event and poses a serious therapeutic challenge as it imparts a poor prognosis. We report a case of concurrent AML with multiple myeloma in a 44-year-old male along with a PUBMED-based research of previously reported similar cases in published literature.

Clinico-Hematological Profile of Acute Leukemia Cases in Bihar: A Multiparameter Study in a Tertiary-Care Hospital

Objective The actual incidence and demographic profile of hematological malignancies are unknown in Bihar because of lack of population-based cancer registry (PBCR) data and specialized tertiary cancer center facilities. The objective of this study was to estimate the prevalence, clinico-hematological profile and subtyping of acute leukemia cases by retrospective medical records.

Materials and Methods A retrospective study was conducted in the Department of Hematology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India, over 2 years from July 2019 to June 2021. A total of 176 cases with relevant clinical features and hematological findings were involved in the study. Medical records were studied and data were retrieved.

Statistical Analysis Data were recorded and analyzed using SPSS version 25.

Results A total of 176 cases with relevant clinical features and hematological findings were involved in the study. Acute myeloid leukemia (AML) was most prevalent (52.8%), followed by acute lymphoblastic leukemia (ALL) (34.1%) and unclassified acute leukemia cases (13.1%). Flow cytometry correlation was available in 150 cases. The ratio of males (62.5%) to females (37.5%) is 1.6:1. There was statistically significant difference in physical examination findings between AML and ALL patients. Splenomegaly, lymphadenopathy, and sternal tenderness were more often seen in ALL than in AML patients (p < 0.05). Pallor was more significantly associated with AML than with ALL patients (p < 0.05). Anemia and leucocytosis were found to be significantly associated with acute leukemia patients (p < 0.000).

Conclusion AML M2 was the most common subtype of AML, and B-ALL was the most common subtype of ALL cases.

Vancomycin-Induced Maturation Arrest with Reactive Promyelocyte Proliferation: A Diagnostic and Therapeutic Challenge

Drug-induced leukopenia is a diagnostic and therapeutic challenge. A detailed clinical history is a must to come to a right diagnosis. Certain drugs are known to cause bone marrow suppression, leukopenia, myeloid maturation arrest, and reactive promyelocyte proliferation. Here, we report an unusual case of vancomycin-induced maturation arrest with marked promyelocyte proliferation in a 47-year-old male patient who was being treated for novel coronavirus disease 2019 (COVID-19) infection. Most times, this reactive promyelocyte proliferation is confused with neoplastic promyelocytes, leading to incorrect diagnosis and management.