Background: Acute myeloid leukemia (AML) is usually associated with coagulopathy and disorders of hemostasis, but cases of ischemic events have been reported. We present a case of AML with recurrent acute limb ischemia and multiple organ infarctions.
Methods and results: A 57-year-old woman diagnosed with AML subtype M1 developed recurrent bilateral acute lower-limb ischemia refractory to multiple thromboembolectomies and bypass grafting. Histopathology revealed that thrombi were composed of leukemic blasts, and computed tomography angiogram incidentally revealed multiple infarctions. She demonstrated a response to chemotherapy, but died of an overwhelming sepsis 22 days after her acute admission.
Conclusions: AML subtype M1 with acute lower-limb ischemia and multiple organ infarctions is associated with a poor prognosis. The role of emergency chemotherapy in reducing the tumour burden and possibly improving the results of vascular interventions needs to be defined. Limb-salvaging surgery should not be delayed but be administered immediately according to the degree of ischemia.
Copyright © 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.