Abstract Ref Number = APCP918
ACUTE MYELOID LEUKEMIA WITH DOWN SYNDROME A SERIAL CASE
Yuke Nelwan,Max Mantik,Stefanus Gunawan
Sam Ratulangi University Sam Ratuangi University
Background : Acute Myeloid Leukemia with Down Syndrome (AML - DS) is a unique entity of AML with superior treatment response and overall survival compared with children non AML-DS.
Case Presentation Summary : Case 1: ARA, female, 1 year 5 months, weight 8 kg, height 76 cm, admitted to hospital with pale and fever. Laboratory Results Hemoglobin: 4.4 g / dL, Hematocrit 13.5%, Leucocyte 51,840 / mm3, Platelets count 5,000 / mm3. Bone Marrow aspiration morphology shows suspect ALL-L1, however the immunophenotyping are positive CD 33, CD 34, CD 117, HLA-DR, CD 13 and conclusion is Myeloid Lineage. DNA analysis GATA 1 positive. She was treated using AML-DS protocol consist of Triple intrathecal drugs (Methotrexate, Dexamethasone and Ara-C), Vincristine 1.5 mg/m2 i.v (max 2 mg) on day 1 and day 8, Daunorubicin 50 mg/m2/day i.v day 8, Cytarabine 100 mg/m2/dose i.v pushed twice a day on day 8 – 12. The protocol was given twice with interval 3 – 4 weeks, from December, 9th 2016 to January, 23th 2017. Pateint have survived until now. Case 2: MBC, female, 1 year and 9 months, weight 9 kg, height 82 cm, admitted to hospital with pale and fever. Laboratory results Hemoglobin 2.8 g / dL, Hematocrit 7.9%, Leucocytes 4,500 / mm3, Platelets count 10,000 / mm3. Echocardiography result is Small Secunder Atrial Septal Defect. Bone marrow aspiration morphology shows AML M2 , immunophenotyping are positive CD 33, CD 36, CD 34, HLA DR, CD 117, CD 13. DNA analysis GATA 1 positive. She was treated using the same AML-DS Protocol from April, 4th 2017 until May, 27th 2017. Two days after completion of therapy, the patient died of bleeding with platelets 13,000 / mm3.
Learning Points/Discussion : AML-DS is treatable in our center. However, the outcome is still poor.
Keywords: Acute Myeloid Leukemia Down Syndrome Chlidren