A 67-year-old female presented with an abnormal complete blood count (CBC) when arriving for an angiogram. An abnormal white blood cell (WBC) differential showed 17% blasts which led her physician to have a bone marrow biopsy performed. The bone marrow aspirate smear showed an increased number of blasts and the bone marrow core biopsy revealed 90% cellularity where normal precursors were replaced by blasts. Flow cytometry and chromosome analysis results were consistent with Acute Myelomonocytic Leukemia (AMML). The patient was placed on FLAG chemotherapy until a goal of 0.9-1.0x10^9/L absolute neutrophil count is achieved, at which time a catheter will be placed to address her cardiac comorbidities. Cardiac disease and AML comorbidities are a commonly encountered issue in oncology patients. Due to this patient’s history of cardiac disease, treating her AML is more complicated in order to ensure that chemotherapy does not worsen her cardiac complications.
Ball milling is used in industry to grind ores, minerals, ceramics, and recently has been implemented to research synthesis of organic compounds. One project is researching nickel catalysis in high speed ball milling for producing substituted cyclooctatetraene compounds. In the process of synthesizing the compounds, Ni, Cr, and Fe residues from the vials and nickel pellets used for the reaction will remain in the product. To analyze for the metals remaining in the product, Inductively Coupled Plasma paired with Mass Spectrometry was used. Initially used as an internal standard, gallium’s mass was found on the spectrometer. It is suspected to be a false positive caused by a FeO+ or FeN+. The product was analyzed using Agilent Technologies 7700 ICP-MS before and after a filtering process. This helped determine how effective the filtering process was removing metals and what concentration remained at the part per billion level (ppb) in the final product. A calibration curve was made with a blank, 1ppb, 5ppb, 10ppb, 25ppb, and 50ppb with Sc as the internal standard. Results showed that chromium is insignificant (<0.0ppb), and iron is approximately 1ppb in concentration. Before the filtration process, nickel is approximately 10ppb, after filtration, nickel’s concentration is insignificant (<0.0ppb).