Secondary Acute Myeloid Leukemia after Polycythemia Vera: A Case Report
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Abstract
Secondary acute myeloid leukemia (AML) can be found as the complication of polycythemia vera (PV) itself or the association with chemotherapy particularly hydroxyurea (HU). Herein we report a case of a 52-year old Thai woman who was diagnosed as PV based on the combination of the erythrocytosis, leukocytosis, thrombocytosis, huge splenomegaly and normal oxygen saturation. She has been treated with continual HU with occasional phlebotomy for nine years. The dose of HU has been adjusted according to the white blood cell count. Finally she develops chronic fever, weight loss, anemia, marked leukocytosis with predominant blasts in the peripheral blood and recurrent huge splenomegaly. The definite diagnosis of secondary AM Lafter PV can be made by the bone marrow immunophenotyping and positive JAK2 V617F mutation. She is treated with the combination of cytosine arabinoside and idarubicin regimen and she can tolerate it well. With this case report, the association of the incident of AML after PV and HU therapy is discussed.
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