Sudden Hearing Loss in a Young Patient with Chronic Myelogenous Leukemia

Hyperleukocytosis is a typical presentation of chronic myelogenous leukemia (CML). It sometimes induces leukostasis, the symptoms of which include visual change, headache, tinnitus, dizziness, and occasional disturbance of consciousness. In the present study, a 26-year-old male patient visited a general physician, who observed marked hyperleukocytosis and referred the patient to our hospital. The patient was diagnosed with CML and treated with a tyrosine kinase inhibitor and hydroxycarbamide. On the fourth day after admission, the patient suddenly complained of left-sided hearing loss. An audiogram revealed profound left sensorineural hearing loss. Magnetic resonance imaging of the head showed no lesions in the inner ear, cerebellum, or brain stem; therefore, we diagnosed sudden hearing loss due to leukostasis. Subsequently, his hearing did not improve, despite a decrease in leukocytes. The pathophysiology of leukocytosis involves increased leukocytes and thrombi, which induce high blood viscosity in the microcirculation. Leukostasis-related infarction and hemorrhage can lead to occlusion of the labyrinthine artery, causing deafness. Physicians should be aware that deafness can develop when diagnosing marked leukocytosis because such deafness is irreversible in most cases

Successful combination treatment with azacitidine and venetoclax as a bridging therapy for third allogenic stem cell transplantation in a patient with 11q23/MLL‐rearranged complex karyotype acute myeloid leukemia

Abstract Translocation t(6;11) occurs in approximately 5% of patients with acute myeloid leukemia (AML) corresponding to 11q23/mixed lineage leukemia (MLL) rearrangement. The AF6 gene on chromosome 6q27 is the fusion partner of the MLL gene on 11q23 in t(6;11), which results in a poor prognosis. The case of a patient with 11q23/MLL‐rearranged AML who successfully underwent a third allogeneic stem cell transplantation after treatment with azacitidine (AZA) and venetoclax (VEN) is presented in this article. This report suggests that a combination of AZA and VEN is an effective therapeutic approach for relapsed and refractory MLL‐rearranged AML