A case of platelet refractoriness in acute myeloid leukaemia: management in a low resource setting
DOI:
https://doi.org/10.60787/tnhj.v16i1.192Keywords:
platelet refractoriness, acute myeloid leukemia, AMLAbstract
Background: Acute myelogenous leukaemia is a type of acute leukaemia more commonly seen in adults than in children and usually presents with features of anaemia, neutropoenia and thrombocytopoenia(pancytopoenia). Red cell transfusions and the use of granulocyte colony stimulating factor usually correct the anaemia and neutropoeniarespectively while platelet concentrates are required for correction of thrombocytopoenia. However, some patients develop platelet refractoriness where they fail to achieve expected increment in platelet count following platelet transfusions which may be fatal because severe thrombocytopoeniamay lead to bleeding into vital organs including the brain.The aim of this report is to document the management of platelet refractorinessin a patient with acute myelogenous leukaemia and paraplegia, with correctionof thrombocytopoeniain a low resource setting.
Methods: Datawasobtained from the case notesof a 14 year old male with acute myelogenous leukaemia and paraplegia who developed platelet refractoriness. A review of literaturewas done by searchingon Google and PubMed.
Results: A 14 year old male who presented with pancytopoenia and paraplegia was diagnosed with acute myelogenous leukaemia. He had multiple transfusions and developed platelet refractoriness. Despite severe thrombocytopoeniaand platelet refractoriness, he was commenced on chemotherapy and achieved remission.
Conclusion: Paraplegia is an uncommon presentation of central nervous system involvement in acute myelogenous leukaemia. Platelet refractoriness is a feared complication occurringinhaematological malignancies. The acute myelogenous leukaemia complicated by platelet refractoriness was treated successfullyina low resource setting.
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