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A 59-year-old man presented with a sudden onset of abdominal pain in the left upper quadrant, associated with low-grade fever and shortness of breath. He had had a recent relapse of acute myelogenous leukemia and had an internal-tandem-duplication mutation of Fms-like tyrosine kinase 3 (FLT3). His white-cell count at admission was 15,900 per cubic millimeter, with 60% monoblasts. Over the next 24 hours, his leukocyte count increased from 29,000 to 102,340 per cubic millimeter, and his monoblast count increased from 5510 to 55,264 per cubic millimeter, despite the administration of cyclophosphamide. The patient's hypoxemia worsened. Mechanical ventilation was initiated, but . . . [Full Text of this Article] |
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