Anusree Prabhakaran
Deenanath Mangeshkar Hospital, India
Title: A rare co-occurrence of AML and Hodgkin’s lymphoma treated with haplo identical stem cell transplant
Biography
Biography: Anusree Prabhakaran
Abstract
Mr J 24/M, was diagnosed with Acute Myeloid Leukemia (AML), with t(8,21), April 2015, when he presented with constitutional symptoms and cytopenias. He was managed with 3+7 induction chemotherapy followed by chemo consolidation with high dose Cytarabine, 3 cycles. He achieved complete remission (CR) and was on close follow up. He sustained relapse in December 2015 and hence was referred to our centre for further management. At admission he had 7% blasts in bone marrow, t(8,21) positive and FLT3/ITD, NPM1 and c-kit mutations negative. Examination revealed cervical and axillary lymphnodes. Possibility of chloroma was considered and he underwent a lymphnode excision biopsy- reported as Hodgkin’s lymphoma (HL) - nodular sclerosing variant. PET CT showed Stage II disease. He received FLAG-M chemotherapy followed by 2 courses of ABVD. Repeat Bone marrow showed refractory AML. Second salvage with Cladribine and Etoposide also failed. He underwent salvage haploidentical transplant, donor being his sister. He received Cyclophosphamide- total body irradiation based (Cy TBI) conditioning regimen and PTCy-Tacrolimus- MMF for GVHD prophylaxis. Post TBI, BM revealed 35% blasts. He had a stormy course peri transplant, with multiple complications. He had neutrophil engraftment on D+18 and was discharged on D+27 post transplant. D+30 bone marrow and D+90 PET CT are in CR. He is now 7 months post-transplant and remains in complete remission for both diseases.