Date | Symptoms | Analyses | Treatment | Notes |
24 Nov 2012 | Moderately differentiated SCC in the left soft palate (ulceration and hard osteonecrosis of soft palate) + partial loss of vision in the left eye + pancytopenia [Leucopenia (WBC 2.6 × 109/l), neutropenia (1.2 × 109/l); anemia (Hgb 7.9 g/dl); thrombocytopenia (Plt 46 × 109/l). | Vit(B12) 138 pg/ml (normal value 243 - 1100), and Vit(B9) 5.47 ng/ml (normal 2.8 - 21). ・ Bone marrow (BM) smear showed almost 20% of blats | 8 cycles radiotherapy for 2 months | Stooped radiotherapy because the pancytopenia continues (WBC 1.9 × 109/l), neutropenia (1.1 × 109/l); Hgb 10.6 g/dl); Plt 39 × 109/l). ・ Vit(B12) deficiency was treated but still suffered from pancytopenia. |
03 Dec 2013 | Peripheral blood (PB) showed pancytopenia (WBC 2.6 × 109/l), neutropenia (1.2 × 109/l); Hgb 7.9 g/dl); Plt 46 × 109/l). | Cytogenetic analyses and immunophenotyping were done at this point. |
| ・ Banding cytogenetics revealed a karyotype 46,XY,der(7)t(1;7)(?;?)[11]/ 46,XY[9] ・ Immunophenotyping result suggested RAEB-2 according to WHO classification. ・ He received several blood Transfusions. |
15 Dec 2013 | Peripheral blood (PB) showed pancytopenia. |
| Thalidomide (50mg three times per day) for two weeks |
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31 Dec 2013 | Intolerance of Thalidomide drug. |
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| Severe nausea, Syncope, Neuropathy. He received blood transfusions. |
07 Jan 2014 | He received several blood transfusions. PB showed pancytopenia (WBC 1.6 × 109/l), neutropenia (1.1 × 109/l); Hgb 6.7 g/dl); Plt 92 × 109/l). |
| Suggested Vidaza (Azacitidine) | No Azacitidine treatment because the political situation in his country. |
11 Feb 2014 |
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| He received Azacitidine (75 mg/m2) (first cycle in the first day) | He received several blood Transfusions. PB showed pancytopenia (WBC 1.8 × 109/l), neutropenia (1.1 × 109/l); Hgb 7.4 g/dl); Plt 67 × 109/l). Later he had bilateral pleural effusion, and heavy ascites. |
24 Feb 2014 | The patient was lost during follow-up. |