Abstract：
A 44-year-old woman was diagnosed with acute myeloid leukemia (RUNX1::RUNX1T1 translocation) and received induction chemotherapy with idarubicin hydrochloride and cytosine arabinoside. The pneumonia that had been present since admission worsened, and a drug-induced skin rash appeared. On day 17, she presented with respiratory failure and shock, complicated by hemoconcentration and hypoalbuminemia. This was considered capillary leak syndrome due to pneumonia and drug allergy, so she was started on pulse steroid therapy and IVIG, and was intubated on the same day. On day 18, venovenous-extracorporeal membrane oxygenation (VV-ECMO) was started due to worsening blood gas parameters despite ventilatory management. Bronchoalveolar lavage fluid was serous, and both blood and sputum cultures yielded negative. The patient was weaned from VV-ECMO on day 26 as the pneumonia improved with recovery of hematopoiesis. She was disoriented, and a CT scan on day 28 revealed cerebral hemorrhage. Her strength recovered with rehabilitation. After induction chemotherapy, RUNX1::RUNX1T1 mRNA was not detected in bone marrow. The patient received consolidation chemotherapy, and has maintained complete remission. Severe respiratory failure during induction chemotherapy for acute leukemia can be fatal, but VV-ECMO may be lifesaving.
摘要：
一名44岁的妇女被诊断出患有急性髓细胞性白血病（RUNX1：：RUNX1T1易位），并接受了盐酸伊达比星和胞嘧啶阿拉伯糖苷的诱导化疗。自入院以来一直存在的肺炎恶化，出现了药源性皮疹。在第17天，她出现呼吸衰竭和休克，并发血液浓缩和低蛋白血症。这被认为是由于肺炎和药物过敏引起的毛细血管渗漏综合征，所以她开始接受脉冲类固醇治疗和IVIG，并在同一天插管。在第18天，尽管进行了通气管理，但由于血气参数恶化，开始了静脉-体外膜氧合（VV-ECMO）。支气管肺泡灌洗液呈浆液性，血液和痰培养均为阴性。患者在第26天从VV-ECMO断奶，因为肺炎随着造血功能的恢复而改善。她迷失方向，28天的CT扫描显示脑出血.她的力量随着康复而恢复。诱导化疗后，RUNX1::在骨髓中未检测到RUNX1T1mRNA。患者接受了巩固化疗，并保持完全缓解。急性白血病诱导化疗期间的严重呼吸衰竭可能是致命的，但是VV-ECMO可能会挽救生命。
