Acute myeloid leukemia of a primary hepatic carcinoma patient after liver transplantation: a case report and literature review

Abstract

Living donor liver transplantation (LDLT) is an important means to treat end-stage liver disease. Although effective immunosuppressant medication greatly assists the survival of patients, it is likely to promote infections and cancer. Acute leukemia (AL) is a rare complication after LDLT and up to now only 1 case of post-transplantation AL has occurred in our liver transplantation center after more than 1,600 LDLT interventions since 1993. In the present report, we describe a rare case of subsequent acute myeloid leukemia (AML), 27 months after LDLT and review the literature of this infrequent complication.

Keywords: Acute myeloid leukemia; alpha-fetoprotein; hepatic carcinoma; liver transplantation; metastases.

Figure 1

Scheme of AFP serum concentrations of the LDLT patients from pre-operation time until AML recurrence. T0 = the time before transplantation; T1 = the first day after transplantation; T2 (December 2008) = the first time we detected lung metastasis; T3 = the time after first pneumoresection; T4 (February 2009) = the second time we detected lung metastasis; T5 (May 2009) = several days after the second time we detected lung metastasis; T6 = time after the second pneumoresection; T7 (December 2009) = the third time we detected lung metastasis; T8 (May 2010) = time before the third pneumoresection; T9 = time after the third pneumoresection; T10 (July 2010) = time after the initial diagnosis of AML; T11 (2010-8-20), T12 (2010-9-1), T13 (2010-11-29), T14 (2011-1-7), T15 (2011-1-17), T16 (2011-2-16) are the times during CR; T17 (April 2011) = first day after the recurrence of AML.