Hemolytic uremic syndrome ( HUS ) as a rare complication of induction chemotherapy for acute myeloid leukemia ( AML ) without maturation

A 75-year-old male was admitted to the hospital in November 2002 with high-grade fever (above 38°C), cough, hypoxia, and progressive general lassitude. Laboratory findings showed the folowing: hemoglobin level, 5.9 g/dl; leukocytes, 31,890/μl with 79.5% blast; platelet count, 26,000/μl; and reticulocytes, 0.877%. There were no morphological abnormalities of the red blood cels at that time. Other significant laboratory findings included serum lactic dehydrogenase (LDH) 1,107 IU/l; blood urea nitrogen (BUN), 35 mg/dl; creatinine, 1.6 mg/dl; and C-reactive protein, 6.2 mg/dl. A bone marrow aspiration was performed. His bone marrow yielded over 90% of blast without diferentiation and with myeloperoxidase and surface marker folowing CD13, CD33 and HLA-DR were positive. He was diagnosed with acute myeloid leukemia without maturation. He received one cycle of remission-induction therapy with 25 mg/m daunorubicin (DNR) on days 1-3 and 200 mg/m behenoyl-ara-C (BHAC) on days 1-7. Sulfamethoxazole/ trimethoprim (ST), ciprofloxacin hydrochloride Yuichi Kato, Katsushi Tajima, Takeo Kato