Cardiac ALL: Most Unusual Occurrence of Lenalidomide-associated Acute Lymphoblastic Leukemia with Subsequent Cardiac Involvement
Leukemic infiltration of the myocardium is an extremely rare complication and requires high clinical suspicion, as
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| Veröffentlicht in: | Curēus (Palo Alto, CA) CA), 2019-10, Vol.11 (10), p.e6009 |
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| container_issue | 10 |
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| creator | Sharma, Naman Hassoun, Hani Hatem, Joseph Kouides, Peter |
| description | Leukemic infiltration of the myocardium is an extremely rare complication and requires high clinical suspicion, as |
| doi_str_mv | 10.7759/cureus.6009 |
| format | Article |
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Commonly encountered cardiovascular complications are secondary to anemia, infections, and chemotherapy. We present an unusual case of biopsy-proven myocardial B-cell acute lymphoblastic leukemia (ALL) in an elderly male on chronic maintenance therapy with lenalidomide, with a previous history of multiple myeloma (MM) and subsequent ALL. Lenalidomide is a Category 1 recommendation for primary and maintenance therapy of MM, but there is growing evidence of secondary primary malignancies (SPMs). Despite this increase in SPM, the overall survival (OS) benefit associated with the use of maintenance immunomodulatory (IMID) therapy in multiple myeloma outweighs the risk of SPMs. Only age-appropriate screening methods are recommended. This case report serves as an important reminder of a rare manifestation of leukemia and presents as anecdotal evidence of response to the monoclonal antibody inotuzumab for visceral involvement of ALL, which has not been reported to our knowledge and requires further exploration.</description><identifier>ISSN: 2168-8184</identifier><identifier>EISSN: 2168-8184</identifier><identifier>DOI: 10.7759/cureus.6009</identifier><identifier>PMID: 31815073</identifier><language>eng</language><publisher>United States: Cureus Inc</publisher><subject>Bone marrow ; Cardiology ; Case reports ; Dyspnea ; Hematology ; Immunotherapy ; Internal Medicine ; Leukemia ; Monoclonal antibodies ; Multiple myeloma ; Oncology ; Patients ; Stem cells ; Targeted cancer therapy ; Transplants & implants ; Tumors ; Ultrasonic imaging</subject><ispartof>Curēus (Palo Alto, CA), 2019-10, Vol.11 (10), p.e6009</ispartof><rights>Copyright © 2019, Sharma et al.</rights><rights>Copyright © 2019, Sharma et al. 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Commonly encountered cardiovascular complications are secondary to anemia, infections, and chemotherapy. We present an unusual case of biopsy-proven myocardial B-cell acute lymphoblastic leukemia (ALL) in an elderly male on chronic maintenance therapy with lenalidomide, with a previous history of multiple myeloma (MM) and subsequent ALL. Lenalidomide is a Category 1 recommendation for primary and maintenance therapy of MM, but there is growing evidence of secondary primary malignancies (SPMs). Despite this increase in SPM, the overall survival (OS) benefit associated with the use of maintenance immunomodulatory (IMID) therapy in multiple myeloma outweighs the risk of SPMs. Only age-appropriate screening methods are recommended. 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| subjects | Bone marrow Cardiology Case reports Dyspnea Hematology Immunotherapy Internal Medicine Leukemia Monoclonal antibodies Multiple myeloma Oncology Patients Stem cells Targeted cancer therapy Transplants & implants Tumors Ultrasonic imaging |
| title | Cardiac ALL: Most Unusual Occurrence of Lenalidomide-associated Acute Lymphoblastic Leukemia with Subsequent Cardiac Involvement |
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