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 1000×10(9)/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 2000×10(9)/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/m(2) 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.