Acute mono-megakaryoblastic leukemia associated with extreme thrombocytosis and complex karyotype abnormalities

Patient: Female, 55 Final Diagnosis: Acute leukemia Symptoms: Thrombocytosis Medication: Idarubicin HCl (Zavedos), Pfizer Clinical Procedure: - Specialty: Hematology. OBJECTIVE Adverse effect of drug therapy. BACKGROUND Thrombocytosis is usually seen in myeloproliferative disorders (MPD) and seldom in acute myeloid leukemias (AML). In acute megakaryoblastic leukemia, platelet counts might exceed 1000×109/L in approximately 30% of patients, while others are frequently presented by cytopenias. To our best knowledge there is no report in the literature on acute mono-megakaryoblastic leukemia, especially with extreme thrombocytosis and complex karyotype abnormalities. CASE REPORT We present the case of a 55-year-old woman with acute mono-megakaryoblastic leukemia with extreme thrombocytosis (greater than 2000×109/L) and complex karyotype abnormalities. The patient was first treated with anti-aggregate therapy and later the patient was put on a regimen consisting of idarubicin 10 mg/m2 daily for 3 days and 200 mg Cytosar daily for 7 days. However, a severe pancytopenia occurred at the first day after chemotherapy and the patient died from intracranial hemorrhage. CONCLUSIONS Extreme thrombocytosis and complex karyotype abnormalities in acute mono-megakaryoblastic leukemia are associated with poor outcome.