Managing acute myeloid leukemia in the context of sickle cell anemia and suspected Fanconi anemia in Tanzania - case report

Sep 30, 2026

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Focusing on a rare co-occurrence, this Tanzania case report describes a 6-year-old Haya boy with congenital left-hand malformation, short stature, and multiple café-au-lait spots, alongside 8 months of recurrent fever, headache, weight loss, and abdominal distension. Clinicians confirmed acute myeloid leukemia and sickle cell anemia with clinically suspicious Fanconi anemia features. Induction therapy failed, leading to family counseling and transition to home-based palliative care, followed by repeated admissions for supportive blood products and death 7 months post-discharge.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Abstract

Introduction

Multihit hypothesis and AML predisposing conditions

Fanconi anemia and its progression to leukemia

Case presentation

Conclusion

Kilipamwambu etal. Journal of Medical Case Reports (2026) 20:11 [https://doi.org/10.1186/s13256-025-05458-x](https://doi.org/10.1186/s13256-025-05458-x) Journal of Medical Case Reports CASE REPORT Open Access Managing acute myeloid leukemia in the context of sickle cell anemia and suspected Fanconi anemia in Tanzania: a case report Amosi Kilipamwambu 1* , Irene Msirikale1, Bernice Mukuria1, Koga Luhulla2,3, Trish Scanlan2,4, Godlove Sandi2, Peter Swai2, Khadija Mwamtemi2, Lulu Chirande1 and Nana Nakiddu 1 Abstract Background The transformation of Fanconi anemia into a hematological malignancy is consistent with the natural history of the disease. Few cases have been reported on acute myeloid leukemia, and even fewer cases involving coexistence with sickle cell anemia. Acute myeloid leukemia development is postulated to follow a multihit hypothesis where preleukaemic cells progress into leukemia through a second promotional mutation. Fever is a predominant clinical presentation, with blasts usually observed on peripheral blood smear and the immunophenotype confirmed with flow cytometry. In this case report from Tanzania, we present a case of acute myeloid leukemia with a failed induction in a patient with Sickle cell anemia and suspected Fanconi anemia. Case presentation A 6-year-old Haya boy from northern Tanzania presented to Muhimbili National Hospital with a congenital malformation of the left hand, short stature, and multiple café-au-lait spots distributed over the trunk, face, and limbs. He had experienced recurrent fever for 8 months, accompanied by headache, weight loss, and abdominal distension. Laboratory evaluation confirmed acute myeloid leukemia and sickle cell anemia with clinically suspicious features of Fanconi anemia. The patient was initiated on institutional treatment for acute myeloid leukemia. He had a failed induction and subsequently transitioned to home-based palliative care after prognostic counseling with the family. Thereafter, he had several admissions, mostly for blood product support, and eventually died 7 months post-discharge. Conclusion The onset of acute myeloid leukemia in this case could be attributed to a malignant transformation from an underlying cancer predisposition syndrome. Our particular focus was on the leukemia treatment response where we observed a failed induction, prompting the need for alternative treatment approaches in this category of patients with acute myeloid leukemia in order to realize better treatment outcomes. Keywords Acute myeloid leukemia, Fanconi anemia, Sickle cell anemia, Tanzania *Correspondence: Amosi Kilipamwambu [aarkilipamwambu@gmail.com](aarkilipamwambu@gmail.com) Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/.)[.](http://creativecommons.org/licenses/by-nc-nd/4.0/.) Kilipamwambu etal. Journal of Medical Case Reports (2

FAQs

What were the key clinical features in the patient?

The patient had congenital malformation of the left hand, short stature, multiple café-au-lait spots, recurrent fever for 8 months, headache, weight loss, and abdominal distension.

How were the diagnoses established?

Laboratory evaluation confirmed acute myeloid leukemia and sickle cell anemia, with features clinically suspicious for Fanconi anemia.

What was the treatment outcome?

Institutional acute myeloid leukemia treatment was initiated, but induction failed; after prognostic counseling, care transitioned to home-based palliative support.

Sep 30, 2026

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