allopurinol and Leukemic-Infiltration

Visual impairment as the initial symptom of leukemia, especially chronic myeloid leukemia, is rare, occurring in approximately 3% of all leukemias in children. We describe the case of a 14-year-old boy with vision loss attributable to bilateral central retinal vein occlusion and massive retinal infiltrates. Bone marrow biopsy demonstrated the BCR-ABL translocation, and the patient was diagnosed with chronic myeloid leukemia. A major cytogenetic remission was achieved 6 months after initiation of therapy.

Topics: Adolescent; Allopurinol; Antineoplastic Agents; Benzamides; Bone Marrow; Drug Therapy, Combination; Humans; Hydroxyurea; Imatinib Mesylate; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemic Infiltration; Male; Piperazines; Proto-Oncogene Proteins c-bcr; Pyrimidines; Retina; Retinal Neoplasms; Retinal Vein Occlusion; Vision Disorders; Visual Acuity

Drug-induced hypersensitivity syndrome (DIHS) is a rare but severe life-threatening, drug-induced, systemic hypersensitivity reaction. We report two patients who developed DIHS during treatment for acute myeloid leukemia. Awareness of DIHS is necessary when systemic eruptions and high fever occur in leukemic patients, especially with rapid hematopoietic recovery after chemotherapies.

Topics: Aged; Allopurinol; Anti-Infective Agents; Antibodies, Viral; Antineoplastic Combined Chemotherapy Protocols; Bone Marrow; Cytarabine; Drug Eruptions; Exanthema Subitum; Female; Fever; Hematopoiesis; Herpesvirus 6, Human; Histiocytosis; Humans; Idarubicin; Immunocompromised Host; Leukemia, Myeloid, Acute; Leukemia, Myelomonocytic, Acute; Leukemic Infiltration; Middle Aged; Skin; Virus Activation

Renal involvement by a malignant infiltrative process is often suspected in patients with bilaterally enlarged kidneys and concurrent malignancies. Acute renal failure (ARF) can rarely occur secondary to such an infiltrative process. We present 2 cases in which ARF is attributable to malignant hematolymphoid infiltration. The first case involves diffuse, bilateral involvement of the kidneys by non-Hodgkin's lymphoma. The patient's renal function improved dramatically after the initiation of chemotherapy, clearly linking the development of ARF to the malignant process. In the second case, infiltration of the kidneys by plasma cell leukemia resulted in dialysis dependence. To our knowledge, this represents the first reported case of ARF attributable to documented renal infiltration by plasma cell leukemia. A review of the potential causes of renal failure in hematolymphoid malignancy, focusing on the direct impact of the infiltrative process and on the spectrum of renal disease in plasma cell dyscrasia, is presented.

Topics: Acute Kidney Injury; Allopurinol; Antimetabolites; Antineoplastic Combined Chemotherapy Protocols; Dexamethasone; Female; Humans; Kidney; Leukemia, Plasma Cell; Leukemic Infiltration; Lymphoma, Non-Hodgkin; Middle Aged; Radiography; Thalidomide; Treatment Outcome