[Successful treatment of cardiac tamponade due to/pericardial infiltration with pericardial drainage and intrapericardial chemotherapy in a patient with acute myeloid leukemia].

Abstract

A 66-year-old man with acute myeloid leukemia with myelodysplasia-related changes (AML-MR) was admitted in April 2024 after presenting with increased peripheral blood blasts. At the initial visit, he had atrial fibrillation but no pericardial effusion. Although treatment with venetoclax and azacitidine reduced peripheral blood blasts, a concurrent cardiac tamponade was observed in May of the same year. Pericardial drainage was performed, and cytology and flow cytometry of the pericardial fluid confirmed a diagnosis of pericardial infiltration due to AML. Pericardial effusion resolved with repeated intrapericardial injections of cytarabine, allowing discontinuation of pericardial drainage. Remission induction therapy with daunorubicin and cytarabine was subsequently administered. Palliative care for AML was given during the cardiac treatment, and pericardial effusion did not occur prior to the patient's death in February 2025.