A Close Association of History of Autoimmunity with Chronic Myelomonocytic Leukemia (CMML) in Contrast to Chronic Myelogenous Leukemia (CML)

Abstract Abstract 1712 Background: Chronic myelomonocytic leukemia (CMML) is a myelodysplastic and myeloproliferative neoplasm (MDS/MPN) characterized by cytopenias, persistent monocytosis, morphologic dysplasia and a tendency to transform to acute myeloid leukemia (AML). Similar to MDS, multiple genetic, molecular, microenvironmental and immunologic mechanisms of pathogenesis have been linked to CMML. Autoimmunity results from inflammation and tissue damage caused by inappropriate T and B cell self-recognition. The prevalence of autoimmunity in the U.S. population (not age adjusted) was estimated to be 3.2% prior to 1996 and is now 5 –8% according to 2004 data with a female prevalence (M: F= 1:3) (http://www.niaid.nih.gov/topics/autoimmune/documents/adccfinal.pdf). The prevalence of autoimmunity is estimated to be higher (10–17%) in MDS and MDS derived AML compared to the general population (Giannouli S et al.2012, Emadi A abstract 2012 ASCO). Recent investigations have shown a close link between autoimmune disorders and cancer. A recent study indicated that a history of autoimmununity might predict a better clinical response to DNA methyltransferase inhibitors (DNMTI) in MDS [Emadi A abstract 2012 ASCO]. The current study was conducted to identify the prevalence of autoimmune diseases in patients with CMML and compare it with the general population and to patients with a non-MDS-related MPN chronic myelogenous leukemia (CML). Methods: A retrospective analysis was performed of a series of 123 patients with CMML at Moffitt Cancer Center diagnosed between January 1999 and June 2011. A consecutive collection of 116 patients who were diagnosed with CML between January 2007 and June 2011 was included for comparison. Patients with a past medical history of autoimmunue disorders e.g. idiopathic thrombocytopenic purpura (ITP), Sjogren's syndrome, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), multiple sclerosis (MS), chronic autoimmune hemolytic anemia, inflammatory bowel diseases (IBD, ulcerative colitis or Crohn disease), psoriasis etc. were retrieved and clinical findings were correlated to published prevalence of these conditions in the general population. Results: Among 123 CMML patients (average age of 68.6, ranging from 30 to 90 y/o, M: F = 2.61), 20 (16.26%, 8 Female, 12 Male) had a history of autoimmune related disorders: RA(3, 2.4%), MS (2, 1.6% ), Sjogren's syndrome (1, 0.8%), IBD(1, 0.8%), autoimmune anemia (1, 0.8%), psoriasis (4, 3.25%), polymyalgia rheumatica (1, 0.8%), ITP(6, 4.9%), hyperthyroidism (2, 1.6%); and 3 patients have more than 1 autoimmune disorder. In addition, 9 of 123 cases (7.3%) had a history of the other malignancies (7 with solid tumors and 2 with hematopoietic neoplasms other than MDS/CMML/AML, but no CML). In the CML group (average age of 55.5, ranging from 21 to 84 y/o, M: F = 1.2), history of autoimmunity was found in 6 of 116 patients (5.2%), which is similar to reports of these conditions in the general population. The autoimmune phenomenon included 2 RA, 2 polymyalgia rheumatica, 1 IBD, and 1 psoriasis. There was a statistically significant difference in the rate of autoimmune diseases between CMML and CML (p=0.0066, X2test). Of note, 5 CMML patients were considered secondary CMML; however, none of the 5 patients in the study had documented autoimmununity in his/her past medical history. Conclusion: The presence of autoimmune disorders is significantly higher in CMML compared to historical data on the general population and Moffitt Cancer Center patients with CML. Identifying autoimmune process in CMML may relevance to development of novel therapeutic strategies. A larger study to explore the detailed relationship between a history of autoimmune diseases and CMML is needed to define the molecular pathogenesis. Disclosures: No relevant conflicts of interest to declare.

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Lymphoproliferative malignancies in patients with neurofibromatosis 1

Orphanet Journal of Rare Diseases ◽

10.1186/s13023-021-01856-8 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Christina Bergqvist ◽

François Hemery ◽

Arnaud Jannic ◽

Salah Ferkal ◽

Pierre Wolkenstein

Keyword(s):

General Population ◽

Medical History ◽

Hodgkin Lymphoma ◽

Incidence Rate ◽

Population Based ◽

Neurofibromatosis 1 ◽

Population Based Study ◽

Non Hodgkin Lymphoma ◽

History Of

AbstractNeurofibromatosis 1 (NF1) is an inherited, autosomal-dominant, tumor predisposition syndrome with a birth incidence as high as 1:2000. A patient with NF1 is four to five times more likely to develop a malignancy as compared to the general population. The number of epidemiologic studies on lymphoproliferative malignancies in patients with NF1 is limited. The aim of this study was to determine the incidence rate of lymphoproliferative malignancies (lymphoma and leukemia) in NF1 patients followed in our referral center for neurofibromatoses. We used the Informatics for Integrated Biology and the Bedside (i2b2) platform to extract information from the hospital’s electronic health records. We performed a keyword search on clinical notes generated between Jan/01/2014 and May/11/2020 for patients aged 18 years or older. A total of 1507 patients with confirmed NF1 patients aged 18 years and above were identified (mean age 39.2 years; 57% women). The total number of person-years in follow-up was 57,736 (men, 24,327 years; women, 33,409 years). Mean length of follow-up was 38.3 years (median, 36 years). A total of 13 patients had a medical history of either lymphoma or leukemia, yielding an overall incidence rate of 22.5 per 100,000 (0.000225, 95% confidence interval (CI) 0.000223–0.000227). This incidence is similar to that of the general population in France (standardized incidence ratio 1.07, 95% CI 0.60–1.79). Four patients had a medical history leukemia and 9 patients had a medical history of lymphoma of which 7 had non-Hodgkin lymphoma, and 2 had Hodgkin lymphoma. Our results show that adults with NF1 do not have an increased tendency to develop lymphoproliferative malignancies, in contrast to the general increased risk of malignancy. While our results are consistent with the recent population-based study in Finland, they are in contrast with the larger population-based study in England whereby NF1 individuals were found to be 3 times more likely to develop both non-Hodgkin lymphoma and lymphocytic leukemia. Large-scale epidemiological studies based on nationwide data sets are thus needed to confirm our findings.

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Past medical history of tumors other than meningioma is a negative prognostic factor for tumor recurrence in meningiomas WHO grade I

Acta Neurochirurgica ◽

10.1007/s00701-021-04780-9 ◽

2021 ◽

Author(s):

Annamaria Biczok ◽

Philipp Karschnia ◽

Raffaela Vitalini ◽

Markus Lenski ◽

Tobias Greve ◽

...

Keyword(s):

Medical History ◽

Tumor Recurrence ◽

Clinical History ◽

Study Endpoint ◽

Past Medical History ◽

Who Grade ◽

Increased Risk ◽

History Of ◽

Meningioma Recurrence ◽

The Impact

Abstract Background Prognostic markers for meningioma recurrence are needed to guide patient management. Apart from rare hereditary syndromes, the impact of a previous unrelated tumor disease on meningioma recurrence has not been described before. Methods We retrospectively searched our database for patients with meningioma WHO grade I and complete resection provided between 2002 and 2016. Demographical, clinical, pathological, and outcome data were recorded. The following covariates were included in the statistical model: age, sex, clinical history of unrelated tumor disease, and localization (skull base vs. convexity). Particular interest was paid to the patients’ past medical history. The study endpoint was date of tumor recurrence on imaging. Prognostic factors were obtained from multivariate proportional hazards models. Results Out of 976 meningioma patients diagnosed with a meningioma WHO grade I, 416 patients fulfilled our inclusion criteria. We encountered 305 women and 111 men with a median age of 57 years (range: 21–89 years). Forty-six patients suffered from a tumor other than meningioma, and no TERT mutation was detected in these patients. There were no differences between patients with and without a positive oncological history in terms of age, tumor localization, or mitotic cell count. Clinical history of prior tumors other than meningioma showed the strongest association with meningioma recurrence (p = 0.004, HR = 3.113, CI = 1.431–6.771) both on uni- and multivariate analysis. Conclusion Past medical history of tumors other than meningioma might be associated with an increased risk of meningioma recurrence. A detailed pre-surgical history might help to identify patients at risk for early recurrence.

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Abstract 1122‐000214: Clinical Factors Associated rTPA Administration in Acute Ischemic Stroke Patients with History of Atrial Fibrillation

Stroke: Vascular and Interventional Neurology ◽

10.1161/svin.01.suppl_1.000214 ◽

2021 ◽

Vol 1 (S1) ◽

Author(s):

Chase A Rathfoot ◽

Camron Edressi ◽

Carolyn B Sanders ◽

Krista Knisely ◽

Nicolas Poupore ◽

...

Keyword(s):

Atrial Fibrillation ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Medical History ◽

Clinical Decision Making ◽

Past Medical History ◽

Clinical Factors ◽

Stroke Patients ◽

Factors Associated ◽

History Of

Introduction : Previous research into the administration of rTPA therapy in acute ischemic stroke patients has largely focused on the general population, however the comorbid clinical factors held by stroke patients are important factors in clinical decision making. One such comorbid condition is Atrial Fibrillation. The purpose of this study is to determine the clinical factors associated with the administration of rtPA in Acute Ischemic Stroke (AIS) patients specifically with a past medical history of Atrial Fibrillation (AFib). Methods : The data for this analysis was collected at a regional stroke center from January 2010 to June 2016 in Greenville, SC. It was then analyzed retrospectively using a multivariate logistic regression to identify factors significantly associated with the inclusion or exclusion receiving rtPA therapy in the AIS/AFib patient population. This inclusion or exclusion is presented as an Odds Ratio and all data was analyzed using IBM SPSS. Results : A total of 158 patients with Atrial Fibrillation who had Acute Ischemic Strokes were identified. For the 158 patients, the clinical factors associated with receiving rtPA therapy were a Previous TIA event (OR = 12.155, 95% CI, 1.125‐131.294, P < 0.040), the administration of Antihypertensive medication before admission (OR = 7.157, 95% CI, 1.071‐47.837, P < 0.042), the administration of Diabetic medication before admission (OR = 13.058, 95% CI, 2.004‐85.105, P < 0.007), and serum LDL level (OR = 1.023, 95% CI, 1.004‐1.042, P < 0.16). Factors associated with not receiving rtPA therapy included a past medical history of Depression (OR = 0.012, 95% CI, 0.000‐0.401, P < 0.013) or Obesity (OR = 0.131, 95% CI, 0.034‐0.507, P < 0.003), Direct Admission to the Neurology Floor (OR = 0.179, 95% CI, 0.050‐0.639, P < 0.008), serum Lipid level (OR = 0.544, 95% CI, 0.381‐0.984, P < 0.044), and Diastolic Blood Pressure (OR = 0.896, 95% CI, 0.848‐0.946, P < 0.001). Conclusions : The results of this study demonstrate that there are significant associations between several clinical risk factors, patient lab values, and hospital admission factors in the administration of rTPA therapy to AIS patients with a past medical history of Atrial Fibrillation. Further research is recommended to determine the extent and reasoning behind of these associations as well as their impact on the clinical course for AIS/AFib patients.

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Osteopetrosis - A Case Series Exploring Complications and Multidisciplinary Management

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.425 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A209-A209

Author(s):

Catherine Stewart ◽

Paul Benjamin Loughrey ◽

John R Lindsay

Keyword(s):

Back Pain ◽

Lumbar Spine ◽

Medical History ◽

Scaphoid Fracture ◽

Past Medical History ◽

Dxa Scan ◽

X Ray ◽

Management Of Complications ◽

History Of ◽

Spine Mri

Abstract Background: Osteopetrosis is a group of rare inherited skeletal dysplasias, with each variant sharing the hallmark of increased bone mineral density (BMD). Abnormal osteoclast activity produces overly dense bone predisposing to fracture and skeletal deformities. Whilst no cure for these disorders exists, endocrinologists play an important role in surveillance and management of complications. Clinical Cases: A 43-year-old female had findings suggestive of increased BMD on radiographic imaging performed to investigate shoulder and back pain. X-ray of lumbar spine demonstrated a ‘rugger jersey’ spine appearance, while shoulder X-ray revealed mixed lucency and sclerosis of the humeral head. DXA scan showed T-scores of +11 at the hip and +12.5 at the lumbar spine. MRI of head displayed bilateral narrowing and elongation of the internal acoustic meatus and narrowing of the orbital foramina. Genetic assessment confirmed autosomal dominant osteopetrosis with a CLCN7 variant. Oral colecalciferol supplementation was commenced and multi-disciplinary management instigated with referral to ophthalmology and ENT teams. A 25-year-old male presented with a seven-year history of low back pain and prominent bony swelling around the tibial tuberosities and nape of neck. Past medical history included repeated left scaphoid fracture in 2008 and 2018. Recovery from his scaphoid fracture was complicated by non-union requiring bone grafting with open reduction and fixation. Plain X-rays of the spine again demonstrated ‘rugger jersey’ spine. DXA scan was notable for elevated T scores; +2.9 at hip and +5.8 lumbar spine. MRI spine showed vertebral endplate cortical thickening and sclerosis at multiple levels. The patient declined genetic testing and is under clinical review. A 62-year-old male was referred to the bone metabolism service following a DXA scan showing T scores of +11. 7 at the hip and +13 at the lumbar spine. His primary complaint was of neck pain and on MRI there was multi-level nerve root impingement secondary to facet joint hypertrophy. Past medical history was significant for a long history of widespread joint pains; previous X-ray reports described generalized bony sclerosis up to 11 years previously. Clinical and radiological monitoring continues. Conclusion: Individuals with osteopetrosis require a multidisciplinary approach to management. There is no curative treatment and mainstay of therapy is supportive with active surveillance for complications.

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Prognostic factors in patients admitted to an urban teaching hospital with COVID-19 infection

10.21203/rs.3.rs-38340/v1 ◽

2020 ◽

Author(s):

Donogh Maguire ◽

Marylynne Woods ◽

Conor Richards ◽

Ross Dolan ◽

Jesse Wilson Veitch ◽

...

Keyword(s):

Heart Failure ◽

Medical History ◽

Teaching Hospital ◽

Prognostic Score ◽

Glasgow Prognostic Score ◽

Early Warning Score ◽

Past Medical History ◽

Urban Teaching ◽

Neutrophil Lymphocyte Ratio ◽

History Of

Abstract BackgroundSevere COVID-19 infection results in a systemic inflammatory response (SIRS). This SIRS response shares similarities to the changes observed during the peri-operative period that are recognised to be associated with the development of multiple organ failure. MethodsElectronic patient records for patients who were admitted to an urban teaching hospital during the initial 7-week period of the COVID-19 pandemic in Glasgow, U.K. (17th March 2020 - 1st May 2020) were examined for routine clinical, laboratory and clinical outcome data. Age, sex, BMI and documented evidence of COVID-19 infection at time of discharge or death certification were considered minimal criteria for inclusion.ResultsOf the 224 patients who fulfilled the criteria for inclusion, 52 (23%) had died at 30-days following admission. COVID-19 related respiratory failure (75%) and multiorgan failure (12%) were the commonest causes of death recorded. Age>70 years (p<0.001), past medical history of cognitive impairment (p<0.001), previous delirium (p<0.001), clinical frailty score>3 (p<0.001), hypertension (p<0.05), heart failure (p<0.01), national early warning score (NEWS) >4 (p<0.01), positive CXR (p<0.01), and subsequent positive COVID-19 swab (p<0.001) were associated with 30-day mortality. CRP>80 mg/L (p<0.05), albumin <35g/L (p<0.05), peri-operative Glasgow Prognostic Score (poGPS) (p<0.05), lymphocytes <1.5 109/l (p<0.05), neutrophil lymphocyte ratio (p<0.001), haematocrit (<0.40 L/L (male) / <0.37 L/L (female)) (p<0.01), urea>7.5 mmol/L (p<0.001), creatinine >130 mmol/L (p<0.05) and elevated urea: albumin ratio (<0.001) were also associated with 30-day mortality.On analysis, age >70 years (O.R. 3.9, 95% C.I. 1.4 – 8.2, p<0.001), past medical history of heart failure (O.R. 3.3, 95% C.I. 1.2 – 19.3, p<0.05), NEWS >4 (O.R. 2.4, 95% C.I. 1.1 – 4.4, p<0.05), positive initial CXR (O.R. 0.4, 95% C.I. 0.2-0.9, p<0.05) and poGPS (O.R. 2.3, 95% C.I. 1.1 – 4.4, p<0.05) remained independently associated with 30-day mortality. Among those patients who tested PCR COVID-19 positive (n=122), age >70 years (O.R. 4.7, 95% C.I. 2.0 - 11.3, p<0.001), past medical history of heart failure (O.R. 4.4, 95% C.I. 1.2 – 20.5, p<0.05) and poGPS (O.R. 2.4, 95% C.I. 1.1- 5.1, p<0.05) remained independently associated with 30-days mortality.ConclusionAge > 70 years and severe systemic inflammation as measured by the peri-operative Glasgow Prognostic Score are independently associated with 30-day mortality among patients admitted to hospital with COVID-19 infection.

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Safety and Efficacy of Various Intravenous Insulin Infusion Rates in Patients With and Without Diabetes Presenting With Hypertriglyceridemia

Annals of Pharmacotherapy ◽

10.1177/10600280211070102 ◽

2022 ◽

pp. 106002802110701

Author(s):

Francisco Ibarra ◽

Kaitlyn Loi ◽

Ann W. Vu

Keyword(s):

Medical History ◽

Insulin Infusion ◽

Case Reports ◽

Retrospective Chart Review ◽

Acute Management ◽

Past Medical History ◽

Safety And Efficacy ◽

Intravenous Insulin ◽

Number Of Patients ◽

History Of

Background The use of IV insulin infusions in the acute management of hypertriglyceridemia has only been evaluated in small observational studies and case reports. Objective To evaluate the safety and efficacy of IV insulin infusions in the acute management of hypertriglyceridemia. Methods This was a retrospective chart review of adult patients who received an IV insulin infusion for the acute management of hypertriglyceridemia. The primary efficacy and safety outcomes were the number of patients who achieved a triglyceride level <500 mg/dL and experienced hypoglycemia (<70 mg/dL), respectively. A subgroup analysis was performed to compare outcomes between patients with and without diabetes, in addition to the IV insulin infusion rate received. Results In the total population (n = 51), there were no statistically significant differences between the insulin intensity groups in the number of patients who achieved TG levels <500 mg/dL. Compared to patients with a past medical history of diabetes, more patients without a past medical history of diabetes achieved triglyceride levels <500 mg/dL (14% vs 53%, respectively, P < 0.001). The number of hypoglycemic events observed in patients with and without a past medical history of diabetes were 5 (14%) and 4 (27%), respectively ( P = 0.023). Conclusion and Relevance Our findings suggest that patients who present with lower initial TG levels are more likely to achieve TG levels <500 mg/dL. To minimize the risk of hypoglycemia providers should consider prescribing a concomitant dextrose infusion and limiting IV insulin infusion rates ≤ 0.075 units/kg/h.

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What Goes Down, Might Come Up!

Pediatric Medical Emergencies ◽

10.1093/med/9780190946678.003.0009 ◽

2020 ◽

pp. 83-94

Author(s):

Sharon E. Mace

Keyword(s):

Weight Gain ◽

Family History ◽

Medical History ◽

Diagnostic Testing ◽

Physical Exam ◽

Past Medical History ◽

Bilious Vomiting ◽

Underlying Illness ◽

History Of ◽

Comprehensive History

In infants, vomiting is usually benign, but it can also portend significant underlying illness or injury. It is important to remember that although vomiting is commonly from the gastrointestinal (GI) tract itself, it may also be due to more generalized, systemic disorders or injuries (non-GI causes). As with most pediatric complaints a comprehensive history and physical exam is critical to direct both diagnostic testing and management. Remember the past medical history in infants includes neonatal history, growth and developmental history (include weight gain), social and family history. A history of bilious vomiting in an infant should always raise concerns occurs with obstruction, therefore, bilious vomiting always warrants evaluation.

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A rare cause of small bowel diaphragm disease presenting with palpated abdominal mass

Journal of Surgical Case Reports ◽

10.1093/jscr/rjz230 ◽

2019 ◽

Vol 2019 (8) ◽

Cited By ~ 1

Author(s):

Aghyad K Danial ◽

Ahmad Al-Mouakeh ◽

Yaman K Danial ◽

Ahmad A Nawlo ◽

Ahmad Khalil ◽

...

Keyword(s):

Abdominal Pain ◽

Small Bowel ◽

Medical History ◽

Rare Complication ◽

Abdominal Mass ◽

Past Medical History ◽

Abdominal Symptoms ◽

Diaphragm Disease ◽

History Of ◽

Specific Symptoms

Abstract Small bowel diaphragm disease is a rare complication related to non-steroidal anti-inflammatory drug (NSAID) use. It presents with non-specific symptoms such as vomiting, abdominal pain, subacute bowel obstruction and occasionally as an acute abdominal condition. We report a case of diaphragm disease in a 33-year-old female who presented with vomiting, constipation and abdominal pain started 5 days earlier. Physical examination revealed palpated abdominal mass. The patient’s past medical history was remarkable for NSAID use. The patient was managed by surgical resection of involved intestine and diagnosis was confirmed by histological examination. Although there are few published cases of diaphragm disease in the medical literature, we recommend that this disease should be considered as one of the differential diagnoses when assessing patients presenting with non-specific abdominal symptoms with remarkable past medical history of NSAID use.

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RAS mutations are rare events in Philadelphia chromosome-negative/bcr gene rearrangement-negative chronic myelogenous leukemia, but are prevalent in chronic myelomonocytic leukemia

Blood ◽

10.1182/blood.v76.6.1214.1214 ◽

1990 ◽

Vol 76 (6) ◽

pp. 1214-1219 ◽

Cited By ~ 79

Author(s):

C Hirsch-Ginsberg ◽

AC LeMaistre ◽

H Kantarjian ◽

M Talpaz ◽

A Cork ◽

...

Keyword(s):

Chronic Myelogenous Leukemia ◽

Philadelphia Chromosome ◽

Point Mutations ◽

Chronic Phase ◽

Chronic Myelomonocytic Leukemia ◽

Myelogenous Leukemia ◽

Ras Oncogene ◽

Ras Mutations ◽

Ras Oncogenes ◽

Myelomonocytic Leukemia

Abstract Previous reports have indicated that mutations of the RAS oncogenes are not associated with the chronic phase of Philadelphia chromosome- positive chronic myelogenous leukemia (Ph1+ CML). However, further studies were needed to determine their association with Ph1- CML and chronic myelomonocytic leukemia (CMML). Therefore, 6 patients with Ph1- CML who were also negative for BCR rearrangements (Ph1-/BCR- CML) and 30 patients with CMML were analyzed for the presence of RAS oncogene point mutations to determine the similarities of these diseases at the molecular level. The assay used the polymerase chain reaction for amplification of the target RAS sequences and panels of specific synthetic oligonucleotide probes for hybridization to wild type and/or mutated sequences. None of the six Ph1-/BCR- CML patients had mutations in the RAS oncogenes, while 17 of 30 (57%) of the CMML patients had RAS oncogene mutations. Eighty percent of the mutations involved substitution of aspartic acid for glycine (G----A) in the 12th or 13th codons of N-ras or K-ras. Furthermore, although not statistically significant, survival studies raise the possibility of shortened survival in patients with RAS oncogene point mutations, with the average survival being 33 months for Ph1-/BCR- CML, 35 months for CMML without point mutations, and 11 months for CMML with RAS mutations. Thus, RAS mutations appear to be associated with CMML and not Ph1-/BCR- chronic phase CML, there is a high propensity for the K-ras or N-ras mutations to involve an G----A substitution in the 12th or 13th codons, and RAS mutations in CMML may relate to prognosis and require further studies.

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Agranulocytosis Associated with Waldenström Macroglobulinemia

Acta Haematologica ◽

10.1159/000489482 ◽

2018 ◽

Vol 140 (1) ◽

pp. 42-45 ◽

Cited By ~ 1

Author(s):

Iuliana Vaxman ◽

Daniel Shepshelovich ◽

Lucille Hayman ◽

Pia Raanani ◽

Meir Lahav

Keyword(s):

Case Report ◽

Febrile Neutropenia ◽

Medical History ◽

Case Reports ◽

Neutropenic Fever ◽

Severe Neutropenia ◽

Past Medical History ◽

Waldenström Macroglobulinemia ◽

Waldenstrom Macroglobulinemia ◽

History Of

Currently, there are only 2 case reports of Waldenström macroglobulinemia (WM) associated with severe neutropenia. This is a case report of a woman with a past medical history of WM who presented with neutropenic fever. The patient’s febrile neutropenia resolved after RCD chemotherapy (cyclophosphamide 750 mg/m2, dexamethasone 20 mg, and rituximab 375 mg/m2). Fourteen days after administration, the neutrophil level had started to rise and normalized after 6 days. To the best of our knowledge, this is the 3rd reported case of agranulocytosis due to WM.

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