Revista de enfermedades coronarias

Fatal Myocardial Infarction Secondary to Daunorubicin in Acute Myeloid Leukemia Patient

Abstract

Abdurahman Ahmad S Alloghbi, Sara B Huff and Danae M Hamouda

Acute myeloid leukemia is a type of cancer in which a myeloid stem cell, in the bone marrow, is altered or transformed. Myeloid stem cells give rise to red blood cells, platelets, and myeloblasts. When the bone marrow is replaced by leukemic cells, there is decreased production of the normal red blood cells, platelets, and white blood cells. This means both the bone marrow and blood are affected, leading to impaired delivery of oxygen and other substances in the body, decreased ability to fight infections and disease, as well as increased risk of bleeding secondary to the inability to create a platelet plug in blood clot formation. Symptoms include fatigue, shortness of breath, easy bruising and bleeding, and increased risk of infections. We present the case of a 46-year-old-woman with acute myeloid leukemia, M2 subtype with cytogenetic finding of inversion 16, whom underwent induction chemotherapy with daunorubicin. The patient’s medical history included extensive cardiovascular disease, making the use of daunorubicin a precarious situation. Even with careful monitoring, the patient experienced a fatal myocardial infarction. This case highlights the use of daunorubicin, an FDA-approved drug for the treatment of acute nonlymphocytic leukemia (myelogenous, monocytic, erythroid) in adults, in a patient with pre-existing heart disease increasing the risk of daunorubicin-induced cardiac toxicity.