Metachronous Occurrence of Acute Myeloid Leukaemia in a Case of Neuroendocrine Tumour.

Q3 Medicine
European journal of case reports in internal medicine Pub Date : 2025-03-10 eCollection Date: 2025-01-01 DOI:10.12890/2025_005233
Abhinav Menon, Dilip Harindran Vallathol, Deepak Charles, Shagos Nair, Karthika Kundil Veetil, Ashok S Komaranchath, Arun R Warrier
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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.

异时发生急性髓系白血病一例神经内分泌肿瘤。
在接受肽受体放射性核素治疗(PRRT)的神经内分泌肿瘤患者中,血液肿瘤是罕见的,尽管对骨髓功能的长期影响仍然是一个感兴趣的领域。我们报告一例老年妇女诊断为胰腺神经内分泌肿瘤(pNET)谁发展急性髓性白血病(AML)而接受PRRT。她接受阿扎胞苷和venetoclax的非化疗方案治疗,导致急性髓性白血病和神经内分泌肿瘤的缓解。该病例强调了PRRT后继发性血液系统恶性肿瘤的潜在风险,并强调了在这种情况下非强化治疗方法在治疗AML中的有效性。学习要点:本病例强调了肽受体放射性核素治疗(PRRT)与奥曲肽在治疗转移性神经内分泌肿瘤(NET)中的顺序使用,并将其过渡到继发性急性髓性白血病(AML)的无化疗方案。靶向放射性核素治疗与分子肿瘤学方法的整合是一种不断发展的治疗范式,可以改变未来的医疗实践。该病例强调了在接受PRRT的患者中检测治疗相关髓系肿瘤的挑战。由于全血细胞减少导致的急性髓性白血病的延迟诊断强调了在接受长期PRRT和生长抑素类似物治疗的患者中需要警惕的血液学监测。两种恶性肿瘤的成功治疗显示了多学科肿瘤委员会在决策中的重要性。它强调内科医生在协调肿瘤护理、识别并发症和实施个性化治疗策略以改善患者预后方面的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
166
审稿时长
8 weeks
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.
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