Abstract
RATIONALE: Cases of acute myeloid leukemia occurring simultaneously with multiple myelomas are rare. To date, only 31 cases have been reported worldwide. The prognosis of these patients is very poor, and it is very important for them to be diagnosed promptly and treated effectively. PATIENT CONCERNS: A 68-year-old male patient was admitted due to the presence of intermittent nosebleeds accompanied by fever for 10 days, in addition to the development of a right neck mass over 3 days. DIAGNOSES: Diagnosis of acute monocytic leukemia (high-risk group) was based on morphology, immunophenotyping, histochemical staining, and chromosomal and genetic test results. The patient's chromosomes were found to be normal, yet next-generation sequencing revealed a TP53 mutation, thus classifying the risk stratification as high risk. The diagnosis of multiple myeloma was diagnosed based on the presence of > 10% myeloma cells and bone marrow biopsy findings suggestive of multiple myeloma. INTERVENTIONS: Azacitidine 100 mg subcutaneous injection on days 1 to 7, in conjunction with hydrocortisone 50 mg every 12 hours, to treat acute myeloid leukemia in conjunction with multiple myeloma. During this course of treatment, the patient was administered anti-infectious therapy. OUTCOMES: The patient developed a brain abscess during treatment and passed away 2 months after hospitalization. LESSONS: The patient's disease was severe and rapidly progressive, and comorbid severe infections and consistent comorbid severe pancytopenia posed challenges in managing this disease. It is hoped that more effective targeted therapies can be explored for such patients.