Differentiation syndrome in acute myeloid leukemia after treatment with azacitidine

We report a case report of hyperleukocytosis, fever, hypotension, pulmonary and pericardial effusions, and acute kidney injury during initial treatment with azacitidine in a patient with AML‐MRC. Collectively, the symptomatology resembled differentiation syndrome. Azacitidine has been previously ass...

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Bibliographic Details
Published in:European journal of haematology 2015-11, Vol.95 (5), p.484-485
Main Authors: Laufer, Christin B., Roberts, Owen
Format: Article
Language:English
Subjects:
Aged
Azacitidine
Azacitidine - administration & dosage
Azacitidine - adverse effects
Differentiation syndrome
Female
Fever - chemically induced
Fever - drug therapy
Fever - pathology
Fever - physiopathology
Humans
Hypotension - chemically induced
Hypotension - drug therapy
Hypotension - pathology
Hypotension - physiopathology
Leukemia, Myeloid, Acute - drug therapy
Leukemia, Myeloid, Acute - pathology
Leukemia, Myeloid, Acute - physiopathology
Pericardial Effusion - chemically induced
Pericardial Effusion - drug therapy
Pericardial Effusion - pathology
Pericardial Effusion - physiopathology
Syndrome
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Summary:We report a case report of hyperleukocytosis, fever, hypotension, pulmonary and pericardial effusions, and acute kidney injury during initial treatment with azacitidine in a patient with AML‐MRC. Collectively, the symptomatology resembled differentiation syndrome. Azacitidine has been previously associated with fever, peripheral edema, and hyperleukocytosis, but its side effect profile has never been described as similar to differentiation syndrome. The patient's deteriorating course quickly turned around after treatment with dexamethasone. This potential reaction, and potential treatment, is important for clinicians to be aware of.
ISSN:0902-4441
1600-0609
DOI:10.1111/ejh.12598