Decitabine-Induced Severe Pancytopenia with Black Hairy Tongue in a Patient with Acute Myeloid Leukemia: A Case Report
Decitabine-Induced Severe Pancytopenia with Black Hairy Tongue in a Patient with Acute Myeloid Leukemia: A Case Report
Abstract
Background: Decitabine in combination with Venetoclax is widely used in elderly patients with Acute Myeloid Leukemia. Profound myelosuppression is expected; however, unusual mucocutaneous manifestations such as black discoloration of the tongue are rarely documented. It has been established that patients can develop significant side effects, including serious myelosuppression, from treatment with decitabine and venetoclax.
Case Presentation: This clinical report describes the development of a blackish discoloration of the dorsal surface of the tongue (black hairy tongue) in a 66-year-old male AML patient who experienced pancytopenia (a decrease in all types of blood cells) while undergoing decitabine-based chemotherapy with venetoclax. The patient developed black hairy tongue due to profound immunosuppression and experienced the following adverse events during his hospital stay: bacteremia, septic shock, maximum grade of all types of blood dyscrasia, itching, thrush, fecal and urine incontinence, worsening/coughing, fever, and poor mitochondrial activity.
Conclusion: This case study illustrates rare oral complications associated with hypomethylating agents in AML patients with significant dyscrasia and emphasizes the need for close monitoring of all oral healthcare needs for patients who are significantly cytopenic.
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