Thrombosis at ascending aorta following chemotherapy in a patient with acute myeloid leukemia

摘要

In March 2010, a 46-year-old Japanese man was diagnosed with FLT3-ITD positive acute myeloid leukemia, with a white blood cell count of 109.2 x 10~9/L, hemoglobin of 10.3 g/dL, and platelets of 3.7 x 10~4/muL. The remission induction chemotherapy including daunorubicin (50 mg/m~2, days 1-5) and cytarabine (100 mg/m~2, days 1-7), started with anti-coagulation therapy. On day 30 after the induction therapy, he complained of sudden severe abdominal pain. An enhanced CT scan revealed a thrombosis of the ascending aorta (Fig. 1, top left), which constitutively had a high risk of systemic multiple thrombosis including a severe cerebrovascular event. Transesophageal ultrasonography, which was useful for dynamic evaluation, also demonstrated floating vegetation at the identical lesion (Fig. 1, top right). Resection of the necrotic colon was performed (Fig. 1, bottom left).