急性骨髓性白血病在肝移植术后的发生率较低。本报告描述了一例发生于异位骨髓外的急性髓系白血病(M4/M5亚型)的病例，该病例是一位50岁的伊朗妇女，因乙型肝炎相关肝硬化（Child C, MELD=22）接受了异体肝移植术。异位肝移植术于2022年1月采用背靠背技术进行。诱导免疫抑制治疗为甲泼尼龙治疗3天，随后采用麦考酚酯、泼尼松和他克莫司的三重免疫抑制方案进行维持治疗。术后约5个月，即2022年6月，患者出现白细胞增多，白细胞计数为99.4×103个/微升，体格检查只显示颈部淋巴结肿大。颈部淋巴结活检结果显示髓样肿瘤。患者立即入院治疗。入院治疗后的8小时内，患者逐渐表现出嗜睡和血氧饱和度下降至约89%。流式细胞仪显示为单核细胞和髓细胞急性骨髓性白血病（M4/M5亚型）。立即开始强化白细胞分选治疗，随后进行诱导治疗。由于诱导治疗过程中发生败血性并发症，进一步化疗被中止，开始广谱抗生素和抗真菌治疗。不幸的是，我们的患者在入院后42天死于严重感染性休克。急性骨髓性白血病在肝移植后是一种罕见的现象，且可能呈迅速致命的临床进展。© 2023. BioMed Central Ltd., 由 Springer Nature 的一部分。

Acute myeloid leukemia is a rare event in post-liver-transplantation recipients. In the present report, we described a case of extramedullary acute myeloid leukemia, M4/M5 subtype, following orthotopic liver transplant.The patient was a 50-year-old Iranian woman who underwent orthotopic liver transplant due to hepatitis B-related cirrhosis (Child C, MELD (model for end-stage liver disease score) = 22). Orthotopic liver transplant was performed using the piggy back technique in January 2022. Induction immunosuppressive therapy was 1 gm methylprednisolone for 3 days followed by a triple maintenance immunosuppressive regimen including mycophenolate mofetil, prednisolone, and tacrolimus. About 5 months after orthotopic liver transplant in June 2022, the patient presented with leukocytosis, with white blood cell count of 99.4 × 103/µl, and physical examination revealed only cervical lymphadenopathy. Biopsy of cervical lymph nodes showed a myeloid tumor. She was immediately hospitalized. Eight hours after hospitalization, the patient gradually developed lethargy and decreased O2 saturation to approximately 89%. Flow cytometry demonstrated the markers of a myelomonocytic acute myeloid leukemia (M4/M5). Cytoreduction was immediately started by intensive leukopheresis followed by induction therapy. Because of a septic complication during the induction therapy, further chemotherapy was discontinued and broad-spectrum antibiotics and antifungal treatments started. Unfortunately, our patient died of severe septic shock 42 days after hospitalization.Acute myeloid leukemia is a rare phenomenon after liver transplantation, and it can follow a rapidly fatal clinical course.© 2023. BioMed Central Ltd., part of Springer Nature.