Acute myelomonocytic leukemia preceded by secondary amenorrhea and presenting with central diabetes insipidus: a case...

The patient, a 28 year-old female, received treatment for secondary amenorrhea two months before her first admission to our hospital. She was later found to have central type diabetes insipidus and acute myelomonocytic leukemia. A diagnosis of panhypopituitarism was established but there was no laboratory or radiological evidence of neuroleukemia. Complete remission was obtained after one course of induction chemotherapy. She received four more courses of chemotherapy including one course of high-dose cytosine arabinoside (Ara-C) and 14-day granulocytic colony-stimulating factor (G-CSF) for peripheral blood stem cell (PBSC) mobilization. Then she received autologous PBSC transplantation (Auto-PBSCT). Unfortunately leukemia relapsed 4 months after transplantation. The patient expired soon due to severe electrolyte imbalance and sepsis. Throughout the whole course, her pituitary function was only partially recovered after treatment and there was no laboratory or radiological evidence of CNS leukemia.