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Acute myeloid leukemia in a 38-year-old hemodialyzed patient with von Hippel-Lindau disease.
[von hippel-lindau disease]
Von
Hippel-
Lindau
disease
(
VHL
disease
)
is
a
hereditary
cancer
predisposition
syndrome
caused
by
mutations
of
the
von
Hippel-
Lindau
tumor
suppressor
gene
.
The
gene
product
,
pVHL
,
regulates
the
level
of
proteins
that
play
a
central
role
in
protecting
cells
against
hypoxia
.
Clinical
hallmarks
of
von
Hippel-
Lindau
disease
are
the
development
of
central
nervous
system
hemangioblastomas
,
renal
cell
carcinoma
,
pheochromocytoma
,
neuroendocrine
tumors
and
endolymphatic
sac
tumors
.
In
this
article
the
case
of
a
38
-
year
old
hemodialyzed
patient
who
became
ill
with
acute
myeloid
leukemia
(
AML
)
three
years
after
being
diagnosed
with
von
Hippel-
Lindau
disease
is
presented
.
After
cytostatic
treatment
the
patient
went
into
complete
hematologic
remission
but
there
was
still
residual
disease
at
the
genetic
level
.
After
consolidation
therapy
patient
developed
bone
marrow
aplasia
and
severe
pneumonia
.
Despite
intensive
treatment
the
patient
died
from
acute
respiratory
failure
.
In
this
paper
we
present
for
the
first
time
a
case
of
von
Hippel-
Lindau
disease
associated
with
acute
myeloid
leukemia
.
No
evidence
of
relationship
between
VHL
disease
and
blood
cancers
has
been
demonstrated
so
far
.
Despite
the
fact
that
there
is
an
increased
risk
of
cancer
development
in
hemodialyzed
patients
,
cancer
is
a
relatively
rare
cause
of
death
in
the
dialysed
population
,
and
the
most
common
malignancies
are
genitourinary
cancers
.
It
seems
likely
that
development
of
acute
myeloid
leukemia
in
patient
with
VHL
disease
can
be
related
to
epigenetic
alterations
of
the
VHL
gene
,
but
further
studies
are
needed
.
Diseases
Validation
Diseases presenting
"still residual disease at the genetic level"
symptom
von hippel-lindau disease
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