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Radioiodine (RI) has been widely used in treatment of hyperthyroidism and thyroid cancer. The development of acute or chronic leukemia is a very rare complication of RI therapy. Here, we report two cases of acute myeloid leukemia occurring after the completion of RI therapy for follicular thyroid carcinoma along with a brief review of literature. [ABSTRACT FROM AUTHOR]

Background: The outcome of acute myeloid leukemia (AML) in low-middle-income countries (LMIC) is dismal due to delayed clinical presentation and infection-related complications. We aimed to analyze the outcome of patients with AML and the factors associated with its prognosis. Methods: A retrospective observational study was conducted at a tertiary care university hospital in North India from January 2015 to December 2019. Results: A total of 137 AML patients (median age 32 year (3–66 years) received intensive chemotherapy during study period. The median delay from diagnosis to treatment was 45 days (6–177 days). Among the 352 febrile neutropenia (FN) episodes analyzed, 175 (49.7%) were culture positive; Gram-negative multi-drug resistant organism (MDRO) sepsis during induction being 57.4% with 34.5% infections due to carbapenem-resistant Enterobacteriaceae (CRE) leading to a mortality rate of 14.6%. The median EFS and OS were 12.0 ± 1.57 (95% CI 8.91–15.08) and 15.0 ± 2.44 (95% CI 10.21–19.78) months respectively. Multivariable analysis revealed significant difference in median OS between favorable vs high risk AML groups (20.0 (95% CI: 12.50–27.49) vs 9.0 (95% CI: 2.99–15.01) months; p = 0.002); time from diagnosis to treatment (< 30 days vs ≥ 30 days; not reached vs 9.0 (95% CI: 6.81–11.18) months; p = 0.001), performance status (1 vs 2 vs 3; not reached vs 12.0 (95% CI: 10.32–13.67) vs 4.0 (95% CI:2.77–5.22); p = 0.001), and attainment of complete remission vs induction failure (not reached vs 6.0 (95% CI: 3.78–8.21); p = 0.002). Conclusion: Patient-related factors like delayed treatment initiation and high incidence of MDRO-associated sepsis are critical determinants of AML outcome in LMIC. [ABSTRACT FROM AUTHOR]

Introduction: A prototype of good prognosis, t(8;21)‐positive AML, has diverse clinical and genetic features which affect its outcome. This study aimed at evaluating the clinico‐pathological spectrum of t(8;21)‐positive AML and ascertaining prognostic factors influencing its outcome in the Indian subcontinent. Methods: A retrospective analysis of 75 cases of t(8;21)‐positive AML diagnosed over a period of six years (2013‐2018) was carried out. Detailed clinical and laboratory data of the patients were collected from the electronic medical records and reviewed. Results: Median age was 19.5 years (range 5‐75 years) with a M:F of 1.7. Myeloid sarcoma was observed in 9.3% cases. There were 85% FAB AML‐M2, 8% AML‐M1, and 7% AML‐M4 subtypes. Prominent morphological characteristics included dyspoiesis in maturing myeloid cells (83%), long thin tapered Auer rods (58%), cytoplasmic vacuoles (58%), eosinophilia (50%), and mast cells (22%). Auer rods in maturing granulocytes (4% cases) were highly suggestive of the translocation. Additional cytogenetic abnormalities were present in 53% cases. Seventy‐one percent (25/35) achieved CR. The overall survival (OS) was 40%, with a median follow‐up of 27 months (range 4‐57 months). None of the hematological or cytogenetic factors correlated with OS, except for the presence of myeloid sarcoma which had a trend toward poor survival (P =.07). Conclusion: Outcome of t(8;21) AML is not influenced by any of the clinico‐pathological parameters, except for a myeloid sarcoma, which may herald a poor prognosis. Recognition of this distinct subtype of AML would facilitate further molecular screening for risk stratification in resource‐constrained settings. [ABSTRACT FROM AUTHOR]

Therapy-related acute myeloid leukemia (t-AML) occurs as a late complication of cytotoxic chemotherapy, which is administered for a primary malignancy. Simultaneous occurrence of breast cancer and AML is very uncommon, with only seven cases reported till 2016.[[5]] Even uncommon is the concurrent presence of metastatic breast cancer and AML in marrow. The impact of therapy-related acute myeloid leukemia (AML) on outcome in 2853 adult patients with newly diagnosed AML. [Extracted from the article]