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Health Profile — Ishamma T M

Demographics

  • Name: Ishamma T M
  • Date of Birth: 1944-07-01 (age ~81)
  • Sex: Female
  • MR No (KIMS Health): 000384802
  • Patient ID (DDRC Agilus): ISHAF2009474182
  • Blood Type: Not yet documented

Emergency Contact / Family

  • Sameer Badarudeen — Son (primary contact, coordinates care remotely via WhatsApp with Dr. Bijay)
  • Nisha — Family member/caretaker (present bedside during hospitalizations; reported transfusion reaction on 2025-12-10)

Insurance

To be provided

Primary Care Provider

Hematologist/Oncologist

Pharmacy

To be provided

Active Problem List

  1. Aml — Acute Myeloid Leukemia with myelodysplasia-related gene mutations (WHO/ICC 2022). Diagnosed November 2025. Adverse-risk molecular category. Mutations: RUNX1, ASXL1, BCOR, SRSF2, STAG2 (all Tier I), NRAS (Tier II). Karyotype 46,XX (normal). Treated with Azacitidine + Venetoclax. Responding to treatment — multi-lineage hematopoietic recovery documented (May 4: WBC, ANC, Plt all normalized; Hb 11.9 approaching normal).
  2. Pancytopenia — Secondary to AML. Hemoglobin nadir 6.8 g/dL, platelets nadir 45K. Resolved May 2026 — all cell lines now normal or near-normal.
  3. Anemia — Chronic, macrocytic (MCV 95.8 fL). Hb improving from 6.8 to 11.9 g/dL (May 4) — only 0.1 g/dL below normal threshold (12.0).
  4. Diabetes Mellitus — Type 2. HbA1c improved from 6.7–6.8% (2025) to 5.7% (Mar 2026). Fructosamine 310 mg/dL (Apr 2026, elevated).
  5. Elevated Esr — ESR 130 mm/hr at diagnosis, improving to 40 mm/hr.
  6. Positive Ana — ANA 2.2 (positive). Anti-dsDNA negative. Clinical significance uncertain in context of AML.

Resolved Conditions (Since Last Update)

  1. Hyponatremia — Resolved May 2026. Na normalized to 142 mmol/L (May 4, first normal since Jan 2026). Apr 20 nadir was 128 (moderate hyponatremia). Concurrent Mg and Cl also normalized. Etiology remains unexplained (SIADH workup never performed). Chronic pattern predates AML (Na 132 in Nov 2022).

Prior Resolved Conditions

  1. Herpes Zoster — Prior history of shingles (date unknown). Zoster vaccine (~Zostavax) given ~2016. Vaccine efficacy likely waned. Acyclovir prophylaxis ongoing during AML treatment.

Active Medications

  • Azacitidine — Chemotherapy (hypomethylating agent) for AML
  • Venetoclax — BCL-2 inhibitor for AML (dose reduced due to posaconazole interaction)
  • Acyclovir — Antiviral prophylaxis (HSV/VZV) since AML diagnosis
  • Posaconazole — Antifungal prophylaxis; enables venetoclax dose reduction via CYP3A4 inhibition
  • Renerve — Neurological B-vitamin supplement (methylcobalamin B12, B6, alpha lipoic acid, folate); once daily oral
  • See Active Medications for full list

Allergies

See Allergy List — Not yet documented

Surgical/Procedural History

  1. Bone Marrow Biopsy 2025 11 20 — Diagnostic BMBx #1. 60% cellularity, atypical mononuclear cell infiltrate, Reticulin Grade 1–2.
  2. Bone Marrow Biopsy 2025 11 28 — BMBx #2 by Dr. Bijay. 2 good cores, aspirate hemodilute. Results discussed Dec 4.
  3. Flow Cytometry 2025 11 28 — ~5% blasts. Dilute sample.
  4. Karyotype 2025 11 29 — 46,XX[10], normal female.
  5. Port Placement 2025 12 09 — Chemo port placed. Delayed for platelet transfusion.
  6. Bone Marrow Biopsy 2025 12 31 — Day 21 Aza-Ven BMBx #3. 25–30% cellularity, Reticulin Grade 1. Treatment response.

Key Health Metrics (Most Recent)

Metric Value Date Trend
Hemoglobin 12.1 g/dL 2026-06-06 RECOVERED TO NORMAL — second sustained normal since diagnosis
WBC 2,500 cells/cumm 2026-06-06 L — leukopenia recovering from June 1 nadir (2200)
Platelets 241 K/cumm 2026-06-06 N — stable normal, bleeding risk resolved
ANC 1,240 cells/cumm 2026-06-06 L — moderate neutropenia, exited severe range (was 990 June 1)
RBC 3.82 M/cumm 2026-06-06 Near-normal — only 0.02 below threshold (3.80-4.80)
MCV 96.3 fL 2026-06-06 H — improved from 100 fL peak (June 1), macrocytosis decreased
Sodium 139 mmol/L 2026-06-06 N — stable normal
Potassium 4.8 mmol/L 2026-06-06 N — stable normal
Creatinine 0.6 mg/dL 2026-06-06 N — stable renal function
ESR 40 mm/hr 2026-02-20 Improving from 130
CRP 13.8 mg/L 2025-11-19 Elevated
HbA1c 5.7% 2026-03-02 Improved from DM range (unreliable in AML)

Historical Context

2022 Episode

Labs from September 2022 (DDRC SRL, referring Dr. Sudheendra Ghosh) showed markedly elevated CRP (128.13 mg/L), elevated ESR (119), elevated WBC (14,770), and elevated IgE (203.1). Etiology of this earlier inflammatory episode is not documented in current raw sources. CBC at that time showed mild anemia (Hb 11.0) but normal WBC and elevated platelets (501K) — a very different picture from the later pancytopenia.

This profile is updated automatically as documents are ingested.

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