Abhinav Menon, Dilip Harindran Vallathol, Deepak Charles, Shagos Nair, Karthika Kundil Veetil, Ashok S Komaranchath, Arun R Warrier
{"title":"Metachronous Occurrence of Acute Myeloid Leukaemia in a Case of Neuroendocrine Tumour.","authors":"Abhinav Menon, Dilip Harindran Vallathol, Deepak Charles, Shagos Nair, Karthika Kundil Veetil, Ashok S Komaranchath, Arun R Warrier","doi":"10.12890/2025_005233","DOIUrl":null,"url":null,"abstract":"<p><p>Haematological neoplasms are rare in patients undergoing peptide receptor radionuclide therapy (PRRT) for neuroendocrine neoplasms, though the long-term effects on bone marrow function remain an area of interest. We report the case of an elderly woman diagnosed with a pancreatic neuroendocrine tumour (pNET) who developed acute myeloid leukaemia (AML) while receiving PRRT. She was treated with a non-chemotherapy regimen of azacitidine and venetoclax, resulting in remission of both AML and the neuroendocrine tumour. This case highlights the potential risk of secondary haematological malignancies following PRRT and underscores the efficacy of a non-intensive therapeutic approach in managing AML in this context.</p><p><strong>Learning points: </strong>This case highlights the sequential use of peptide receptor radionuclide therapy (PRRT) with octreotide in managing a metastatic neuroendocrine tumour (NET) and its transition to a chemotherapy-free regimen for secondary acute myeloid leukaemia (AML). The integration of targeted radionuclide therapy with molecular oncology approaches is an evolving treatment paradigm that can modify future medical practice.The case underscores the challenge of detecting therapy-related myeloid neoplasms in patients undergoing PRRT. The delayed diagnosis of AML due to pancytopenia highlights the need for vigilant haematologic monitoring in patients receiving long-term PRRT and somatostatin analogue therapy.The successful management of both malignancies showcases the importance of multidisciplinary tumour boards in decision-making. It emphasises the role of internists in coordinating oncology care, recognising complications and implementing individualised treatment strategies to improve patient outcomes.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"12 4","pages":"005233"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013230/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European journal of case reports in internal medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.12890/2025_005233","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Haematological neoplasms are rare in patients undergoing peptide receptor radionuclide therapy (PRRT) for neuroendocrine neoplasms, though the long-term effects on bone marrow function remain an area of interest. We report the case of an elderly woman diagnosed with a pancreatic neuroendocrine tumour (pNET) who developed acute myeloid leukaemia (AML) while receiving PRRT. She was treated with a non-chemotherapy regimen of azacitidine and venetoclax, resulting in remission of both AML and the neuroendocrine tumour. This case highlights the potential risk of secondary haematological malignancies following PRRT and underscores the efficacy of a non-intensive therapeutic approach in managing AML in this context.
Learning points: This case highlights the sequential use of peptide receptor radionuclide therapy (PRRT) with octreotide in managing a metastatic neuroendocrine tumour (NET) and its transition to a chemotherapy-free regimen for secondary acute myeloid leukaemia (AML). The integration of targeted radionuclide therapy with molecular oncology approaches is an evolving treatment paradigm that can modify future medical practice.The case underscores the challenge of detecting therapy-related myeloid neoplasms in patients undergoing PRRT. The delayed diagnosis of AML due to pancytopenia highlights the need for vigilant haematologic monitoring in patients receiving long-term PRRT and somatostatin analogue therapy.The successful management of both malignancies showcases the importance of multidisciplinary tumour boards in decision-making. It emphasises the role of internists in coordinating oncology care, recognising complications and implementing individualised treatment strategies to improve patient outcomes.
期刊介绍:
The European Journal of Case Reports in Internal Medicine is an official journal of the European Federation of Internal Medicine (EFIM), representing 35 national societies from 33 European countries. The Journal''s mission is to promote the best medical practice and innovation in the field of acute and general medicine. It also provides a forum for internal medicine doctors where they can share new approaches with the aim of improving diagnostic and clinical skills in this field. EJCRIM welcomes high-quality case reports describing unusual or complex cases that an internist may encounter in everyday practice. The cases should either demonstrate the appropriateness of a diagnostic/therapeutic approach, describe a new procedure or maneuver, or show unusual manifestations of a disease or unexpected reactions. The Journal only accepts and publishes those case reports whose learning points provide new insight and/or contribute to advancing medical knowledge both in terms of diagnostics and therapeutic approaches. Case reports of medical errors, therefore, are also welcome as long as they provide innovative measures on how to prevent them in the current practice (Instructive Errors). The Journal may also consider brief and reasoned reports on issues relevant to the practice of Internal Medicine, as well as Abstracts submitted to the scientific meetings of acknowledged medical societies.