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Rhabdomyolysis in patients with acute lymphoblastic leukemia
M Morales-Polanco1, F Javier Jímenez-Balderas, L Butrón
1Departamento de Hematologia, Instituto Mexicano del Seguro Social, México D.F.
Archives of Medical Research
|September 18, 1997
Summary
Five acute leukemia patients developed rhabdomyolysis after chemotherapy. This condition, marked by severe muscle pain, was likely caused by a combination of treatments and complications during myelosuppression.
Area of Science:
- Oncology
- Neurology
- Pathology
Background:
- Acute leukemia (AL) treatment often involves intensive chemotherapy.
- Cytosine arabinoside (ARA-C) is a common chemotherapeutic agent used in AL regimens.
- Myelosuppression is a frequent side effect of chemotherapy, increasing infection risk.
Observation:
- Five consecutive cases of rhabdomyolysis (RML) were observed in acute leukemia patients post-chemotherapy.
- Patients experienced severe myalgias, fever, infectious complications, and gastrointestinal symptoms during myelosuppression.
- Elevated creatine kinase (CK) and liver enzymes were noted in affected patients.
Findings:
- Muscle biopsies confirmed focal rhabdomyolysis in all five patients.
- Rhabdomyolysis developed 10-17 days after chemotherapy administration.
- Potential contributing factors included chemotherapy, dehydration, infection, and antibiotic use.
Implications:
- Chemotherapy, particularly with ARA-C, may contribute to RML in acute leukemia patients.
- Concurrent factors like dehydration and infection can exacerbate chemotherapy-induced RML.
- Awareness of RML as a potential complication is crucial for managing acute leukemia patients.