A previously fit and healthy 63-year-old lady from Bangalore was visiting her sister in Bangkok in August 2022. She fell ill acutely with breathlessness, fever, bleeding patches over skin and generalized weakness. Initial evaluation in Emergency Department at a Bangkok hospital revealed extremely high white blood cell (WBC) count of 276400/mm3 (normal range 4000 to 11000), with very low hemoglobin and platelet count.
She was adamant about returning to Bangalore, although she was warned about the high risk of death during the flight journey. After platelet transfusion and hyperhydration, she took the risk and travelled to Bangalore. Upon arrival, she was transported in an ambulance from KIA to hospital and was immediately confirmed by the hemato-oncology team (Dr Anoop P, Dr CN Patil, Dr Sneha K) to have acute myeloid leukemia (AML). In view of her elderly age, extremely high WBC count and poor general condition, the family was updated that despite treatment it would be unlikely that the leukemia will get under control. They decided to take a chance and consented for chemotherapy and its complications, including infections and death.
After the first cycle of induction which lasted 4 weeks, her blood and bone marrow were free from leukemia. During induction, VA had required 20 days in intensive care unit, was intubated, ventilated and unconscious. Her fighting spirit and family support helped the treating team to carry on with intensive measures. Currently in May 2023, She is independent, needing occasional blood and platelet transfusions, with normal WBC count and is on injections for 5 days per month. Her disease is not in a curable stage as the treatment had to be de-escalated after the initial cycle of induction and severe complications. However, in her own words, since that initial day in Bangkok hospital where mortality was thought to be above 90%, she sees every day as a bonus and a blessing.
We salute the positive spirit and never-give-up without a fight attitude of the patient, her husband, daughter and other close family members!
