1
|
Sobas M, Knopinska-Posluszny W, Piątkowska-Jakubas B, García-Álvarez F, Díez MEA, Caballero M, Martínez-Cuadrón D, Aguiar E, González-Campos J, Garrido A, Algarra L, Salamero O, de la Serna J, Sayas MJ, Perez-Encinas MM, Vives S, Vidriales B, Labrador J, Prado AI, Celebrin L, Mayer J, Brioso J, de Laiglesia A, Bergua JM, Amigo ML, Rodriguez-Medina C, Polo M, Pluta A, Cichocka E, Skarupski M, Sanz MA, Wierzbowska A, Montesinos P. Incidence, risk factors, and outcomes of second neoplasms in patients with acute promyelocytic leukemia: the PETHEMA-PALG experience. Ann Hematol 2024; 103:451-461. [PMID: 38110588 PMCID: PMC10799093 DOI: 10.1007/s00277-023-05582-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 12/05/2023] [Indexed: 12/20/2023]
Abstract
The most important challenges in acute promyelocytic leukemia (APL) is preventing early death and reducing long-term events, such as second neoplasms (s-NPLs). We performed a retrospective analysis of 2670 unselected APL patients, treated with PETHEMA "chemotherapy based" and "chemotherapy free" protocols. Only de novo APL patients who achieved complete remission (CR) and completed the three consolidation cycles were enrolled into the analysis. Out of 2670 APL patients, there were 118 (4.4%) who developed s-NPLs with the median latency period (between first CR and diagnosis of s-NPL) of 48.0 months (range 2.8-231.1): 43.3 (range: 2.8-113.9) for s-MDS/AML and 61.7 (range: 7.1-231.1) for solid tumour. The 5-year CI of all s-NPLs was of 4.43% and 10 years of 7.92%. Among s-NPLs, there were 58 cases of s-MDS/AML, 3 cases of other hematological neoplasms, 57 solid tumours and 1 non-identified neoplasm. The most frequent solid tumour was colorectal, lung and breast cancer. Overall, the 2-year OS from diagnosis of s-NPLs was 40.6%, with a median OS of 11.1 months. Multivariate analysis identified age of 35 years (hazard ratio = 0.2584; p < 0.0001) as an independent prognostic factor for s-NPLs. There were no significant differences in CI of s-NPLs at 5 years between chemotherapy-based vs chemotherapy-free regimens (hazard ratio = 1.09; p = 0.932). Larger series with longer follow-up are required to confirm the potential impact of ATO+ATRA regimens to reduce the incidence of s-NPLs after front-line therapy for APL.
Collapse
Affiliation(s)
- Marta Sobas
- Department of Hematology, Blood Neoplasm and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland.
| | | | | | | | | | - Mar Caballero
- Hospital Insular de Las Palmas, Las Palmas de Gran Canaria, Spain
| | | | | | | | | | | | | | | | | | | | - Susana Vives
- Hospital U. Germans Trias i Pujol ICO, Badalona, Spain
| | - Belén Vidriales
- University Hospital of Salamanca (CAUSA/IBSAL) and Center for Biomedical Research in Network of Cancer (CIBERONC), Salamanca, Spain
| | - Jorge Labrador
- Department of Hematology, Research Unit, Hospital Universitario de Burgos, Facultad de Ciencias de la Salud, Universidad Isabel I, Burgos, Spain
| | | | | | - Jiri Mayer
- University Hospital Brno, Masaryk University, Brno, Czechia
| | | | | | | | | | | | - Marta Polo
- Hospital Clínico San Carlos, Madrid, Spain
| | | | | | - Marek Skarupski
- Faculty of Pure and Applied Mathematics, Wrocław University of Science and Technology, Wroclaw, Poland
- Department of Mathematics and Computer Science, Eindhoven University of Technology, 5612, AZ, Eindhoven, The Netherlands
| | - Miguel A Sanz
- Hospital Universitario i Politècnico la Fe, Valencia, Spain
| | | | - Pau Montesinos
- Hospital Universitario i Politècnico la Fe, Valencia, Spain
| |
Collapse
|
2
|
Fu S, Li M, Wang H. BCR-ABL1-positive acute lymphoblastic leukemia following successful treatment of acute promyelocytic leukemia: case report. Front Pharmacol 2023; 14:1141311. [PMID: 37397496 PMCID: PMC10311545 DOI: 10.3389/fphar.2023.1141311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 06/05/2023] [Indexed: 07/04/2023] Open
Abstract
Acute promyelocytic leukemia (APL) is currently considered a disease with a higher cure rate. And cases of secondary malignant tumors following successful APL treatment are rare. Here we described a rare case of a 29-year-old man who was treated for APL in 2019 and developed BCR-ABL1-positive acute lymphoblastic leukemia 2 years later. The patient responded well to tyrosine kinase inhibitors and chemotherapy, and achieved a molecular remission. Although APL usually has a good prognosis, the prognosis of its secondary malignancies is uncertain. There are no effective measures to prevent the occurrence of secondary tumors. Continuing to increase the monitoring frequency of laboratory tests, especially the molecular biomarkers, is essential for the diagnosis and treatment of secondary malignancies after the patients achieving complete remission.
Collapse
Affiliation(s)
- Shuang Fu
- Department of Hematology Laboratory, Shengjing Hospital of China Medical University, Shenyang, China
| | - Mengqi Li
- Department of Hematology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Hongtao Wang
- Department of Hematology, Shengjing Hospital of China Medical University, Shenyang, China
| |
Collapse
|
3
|
Gong Y, Wang M, Shen H, Chen Y, Cen J, Yin X, Yao L. Novel MLL/KMT2A-MON2 fusion in a child with therapy-related acute myeloid leukemia after treatment for acute promyelocytic leukemia. Mol Carcinog 2021; 60:721-725. [PMID: 34236108 DOI: 10.1002/mc.23333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/25/2021] [Accepted: 06/26/2021] [Indexed: 11/12/2022]
Abstract
Acute promyelocytic leukemia (APL) is a distinct subtype of acute myeloid leukemia (AML), which is characterized by the reciprocal t (15;17) (q24; q21) translocation, resulting in PML-RARA gene fusion. Therapy-related AML (t-AML) is a serious complication after cytotoxic and/or radiation therapy in many malignant diseases. In this report, MLL/KMT2A-MON2, with balanced chromosomal translocation t (11;12) (q23; q14), was identified as a novel fusion in a child transformed to t-AML after successful treatment of APL. This study emphasized that clinical monitoring with an integrated laboratory approach is essential for the diagnosis and treatment of t-AML.
Collapse
Affiliation(s)
- Yanlei Gong
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, P.R China.,Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Man Wang
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, P.R China
| | - Hongjie Shen
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, P.R China
| | - Yan Chen
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, P.R China
| | - Jiannong Cen
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, P.R China
| | - Xiaolin Yin
- Department of Hematology, The 923rd Hospital of Joint Logistics Support Force of People's Liberation Army, Nanning, China
| | - Li Yao
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, P.R China.,Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| |
Collapse
|
4
|
Wang Z, Xu MZ, Chen YF, Xue F, Zhang L, Hu YM, Li CW, Li SZ, Wang JX, Mi YC. [Therapy-related myeloid neoplasms after successful treatment for acute promyelocytic leukemia: a report of four cases and literature review]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2020; 40:1008-1014. [PMID: 32023731 PMCID: PMC7342672 DOI: 10.3760/cma.j.issn.0253-2727.2019.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
目的 探讨急性早幼粒细胞白血病(APL)患者继发治疗相关性髓系肿瘤(t-MN)的临床特点、诊断、治疗及预后。 方法 回顾性分析中国医学科学院血液病医院2012年10月至2019年1月收治的4例APL继发t-MN患者的临床资料,并进行相关文献复习。 结果 4例APL继发t-MN患者均为女性,中位年龄42(40~53)岁,3例接受了以维甲酸(ATRA)+亚砷酸(ATO)为基础联合蒽环/蒽醌类药物±阿糖胞苷的前期诱导缓解及巩固治疗方案,1例采用了ATRA联合蒽环/蒽醌类药物±阿糖胞苷的治疗方案,均没有使用烷化剂。在APL获得完全缓解(CR)后40~43个月出现t-MN,其中治疗相关性骨髓增生异常综合征(t-MDS)1例,治疗相关性急性髓系白血病(t-AML)3例,出现t-MN时PML-RARα融合基因均为阴性。3例t-AML患者接受了2~4个疗程再诱导治疗,其中有1例t-AML患者在获得CR后行异基因造血干细胞移植(allo-HSCT),1例t-MDS患者接受了去甲基化治疗。中位随访54.5(48~62)个月,2例t-AML患者死亡,出现t-MN后中位生存期为12(5~18)个月。1989至2018年文献共报道63例APL继发t-MN病例,与本次报道的4例汇总分析,67例患者中男27例,女40例;中位年龄为52.5(15~76)岁;中位潜伏期39(12~168)个月,确诊t-MN后中位生存时间为10(1~39)个月。 结论 APL继发t-MN较为少见,目前缺乏有效的防治措施,预后不佳,在随访过程中(尤其是获得CR后39个月左右)若出现病情变化,应警惕t-MN的发生,对此类患者应尽快明确疾病的变化,给予合理的治疗。
Collapse
Affiliation(s)
- Z Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Instituteof Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - M Z Xu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Instituteof Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Y F Chen
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Instituteof Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - F Xue
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Instituteof Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - L Zhang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Instituteof Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Y M Hu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Instituteof Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - C W Li
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Instituteof Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - S Z Li
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Instituteof Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - J X Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Instituteof Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Y C Mi
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Instituteof Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| |
Collapse
|
5
|
|
6
|
Adès L, Thomas X, Bresler AG, Raffoux E, Spertini O, Vey N, Marchand T, Récher C, Pigneux A, Girault S, Deconinck E, Gardin C, Tournilhac O, Lambert JF, Chevallier P, de Botton S, Lejeune J, Dombret H, Chevret S, Fenaux P. Arsenic trioxide is required in the treatment of newly diagnosed acute promyelocytic leukemia. Analysis of a randomized trial (APL 2006) by the French Belgian Swiss APL group. Haematologica 2018; 103:2033-2039. [PMID: 30026341 PMCID: PMC6269295 DOI: 10.3324/haematol.2018.198614] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 07/17/2018] [Indexed: 12/26/2022] Open
Abstract
In standard-risk acute promyelocytic leukemia, recent results have shown that all-trans retinoic acid plus arsenic trioxide combinations are at least as effective as classical all-trans retinoic acid plus anthracycline-based chemotherapy while being less myelosuppressive. However, the role of frontline arsenic trioxide is less clear in higher-risk acute promyelocytic leukemia, and access to arsenic remains limited for front-line treatment of standard-risk acute promyelocytic leukemia in many countries. In this randomized trial, we compared arsenic, all-trans retinoic acid and the "classical" cytarabine for consolidation treatment (after all-trans retinoic acid and chemotherapy induction treatment) in standard-risk acute promyelocytic leukemia, and evaluated the addition of arsenic during consolidation in higher-risk disease. Patients with newly diagnosed acute promyelocytic leukemia with a white blood cell count <10x109/L, after an induction treatment consisting of all-trans retinoic acid plus idarubicin and cytarabine, received consolidation chemotherapy with idarubicin and cytarabine, arsenic or all-trans retinoic acid. Patients with a white blood cell count >10x109/L received consolidation chemotherapy with or without arsenic. Overall, 795 patients with acute promyelocytic leukemia were enrolled in this trial. Among those with standard-risk acute promyelocytic leukemia (n=581), the 5-year event-free survival rates from randomization were 88.7%, 95.7% and 85.4% in the cytarabine, arsenic and all-trans retinoic acid consolidation groups, respectively (P=0.0067), and the 5-year cumulative incidences of relapse were was 5.5%, 0% and 8.2%. (P=0.001). Among those with higher-risk acute promyelocytic leukemia (n=214), the 5-year event-free survival rates were 85.5% and 92.1% (P=0.38) in the chemotherapy and chemotherapy plus arsenic groups, respectively, and the corresponding 5-year cumulative incidences of relapse were 4.6% and 3.5% (P=0.99). Given the prolonged myelosuppression that occurred in the chemotherapy plus arsenic arm, a protocol amendment excluded cytarabine during consolidation cycles in the chemotherapy plus arsenic group, resulting in no increase in relapse. Our results therefore advocate systematic introduction of arsenic in the first-line treatment of acute promyelocytic leukemia, but probably not concomitantly with intensive chemotherapy, a situation in which we found myelosuppression to be significant. (ClinicalTrials.gov Identifier: NCT00378365).
Collapse
Affiliation(s)
- Lionel Adès
- Hopital Saint Louis, Université Paris Diderot, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Julie Lejeune
- Hopital Saint Louis, Université Paris Diderot, France
| | - Hervé Dombret
- Hopital Saint Louis, Université Paris Diderot, France
| | | | - Pierre Fenaux
- Hopital Saint Louis, Université Paris Diderot, France
| |
Collapse
|
7
|
Gaut D, Sasine J, Schiller G. Secondary clonal hematologic neoplasia following successful therapy for acute promyelocytic leukemia (APL): A report of two cases and review of the literature. Leuk Res Rep 2018; 9:65-71. [PMID: 29892552 PMCID: PMC5993360 DOI: 10.1016/j.lrr.2018.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 03/16/2018] [Accepted: 04/07/2018] [Indexed: 11/27/2022] Open
Abstract
Although rare, secondary clonal hematologic neoplasia may occur after successful therapy for acute promyelocytic leukemia (APL). These secondary clonal events may be considered therapy-related, but may also be due to an underlying background of clonal hematopoiesis from which both malignancies may develop. In this manuscript, we describe two patients with secondary clones after APL therapy characterized in one patient by deletion of chromosome 11q23 and, in the other, by monosomy of chromosome 7, and also provide a review of all secondary clonal disorders described after APL therapy. We suggest that since most reports identify karyotypic abnormalities not typically associated with chemotherapy, there may be another mechanism underlying secondary clonal development after complete response to initial APL therapy.
Collapse
Key Words
- 6-MP, 6-mercaptopurine
- AML, acute myelocytic leukemia
- APL, acute promyelocytic leukemia
- ATG, antithymyocyte globulin
- ATO, arsenic trioxide
- ATRA, all-trans retinoic acid
- Acute myelocytic leukemia (AML)
- CR, complete remission
- FISH, fluorescence in situ hybridization
- MDS, myelodysplastic syndrome
- Myelodysplastic syndrome (MDS)
- PML-RARalpha, promyelocytic leukemia/Retinoic acid receptor alpha
- Secondary clone
- Therapy-related acute myelocytic leukemia (t-AML)
- Therapy-related myelodysplastic syndrome (t-MDS)
- t- MDS, therapy-related myelodysplastic syndrome
- t-AML, therapy-related acute myelocytic leukemia
Collapse
Affiliation(s)
- Daria Gaut
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, LA, California, USA
| | - Joshua Sasine
- Division of Hematology/Oncology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, LA, California, USA
| | - Gary Schiller
- Division of Hematology/Oncology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, LA, California, USA
| |
Collapse
|
8
|
McCulloch D, Brown C, Iland H. Retinoic acid and arsenic trioxide in the treatment of acute promyelocytic leukemia: current perspectives. Onco Targets Ther 2017; 10:1585-1601. [PMID: 28352191 PMCID: PMC5359123 DOI: 10.2147/ott.s100513] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Acute promyelocytic leukemia (APL) is a distinct subtype of acute myeloid leukemia (AML) with a unique morphological appearance, associated coagulopathy and canonical balanced translocation of genetic material between chromosomes 15 and 17. APL was first described as a distinct subtype of AML in 1957 by Dr Leif Hillestad who recognized the pattern of an acute leukemia associated with fibrinolysis, hypofibrinogenemia and catastrophic hemorrhage. In the intervening years, the characteristic morphology of APL has been described fully with both classical hypergranular and variant microgranular forms. Both are characterized by a balanced translocation between the long arms of chromosomes 15 and 17, [t(15;17)(q24;q21)], giving rise to a unique fusion gene PML-RARA and an abnormal chimeric transcription factor (PML-RARA), which disrupts normal myeloid differentiation programs. The success of current treatments for APL is in marked contrast to the vast majority of patients with non-promyelocytic AML. The overall prognosis in non-promyelocytic AML is poor, and although there has been an improvement in overall survival in patients aged <60 years, only 30%-40% of younger patients are still alive 5 years after diagnosis. APL therapy has diverged from standard AML therapy through the empirical discovery of two agents that directly target the molecular basis of the disease. The evolution of treatment over the last 4 decades to include all-trans retinoic acid and arsenic trioxide, with chemotherapy limited to patients with high-risk disease, has led to complete remission in 90%-100% of patients in trials and rates of overall survival between 86% and 97%.
Collapse
Affiliation(s)
- Derek McCulloch
- Institute of Hematology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Christina Brown
- Institute of Hematology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Harry Iland
- Institute of Hematology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| |
Collapse
|
9
|
Rapid expansion of preexisting nonleukemic hematopoietic clones frequently follows induction therapy for de novo AML. Blood 2015; 127:893-7. [PMID: 26631115 DOI: 10.1182/blood-2015-10-677021] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 11/24/2015] [Indexed: 02/06/2023] Open
Abstract
There is interest in using leukemia-gene panels and next-generation sequencing to assess acute myelogenous leukemia (AML) response to induction chemotherapy. Studies have shown that patients with AML in morphologic remission may continue to have clonal hematopoiesis with populations closely related to the founding AML clone and that this confers an increased risk of relapse. However, it remains unknown how induction chemotherapy influences the clonal evolution of a patient's nonleukemic hematopoietic population. Here, we report that 5 of 15 patients with genetic clearance of their founding AML clone after induction chemotherapy had a concomitant expansion of a hematopoietic population unrelated to the initial AML. These populations frequently harbored somatic mutations in genes recurrently mutated in AML or myelodysplastic syndromes and were detectable at very low frequencies at the time of AML diagnosis. These results suggest that nonleukemic hematopoietic stem and progenitor cells, harboring specific aging-acquired mutations, may have a competitive fitness advantage after induction chemotherapy, expand, and persist long after the completion of chemotherapy. Although the clinical importance of these "rising" clones remains to be determined, it will be important to distinguish them from leukemia-related populations when assessing for molecular responses to induction chemotherapy.
Collapse
|
10
|
Therapy-induced secondary acute myeloid leukemia with t(11;19)(q23;p13.1) in a pediatric patient with relapsed acute promyelocytic leukemia. J Pediatr Hematol Oncol 2014; 36:e546-8. [PMID: 24942021 DOI: 10.1097/mph.0000000000000183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Acute myeloid leukemia is classified based upon recurrent cytogenetic abnormalities. The t(15;17)(q24.1;q21.1) abnormality is found in 5% to 8% of de novo acute myeloid leukemia and is diagnostic of acute promyelocytic leukemia (APL). The translocation results in fusion of the retinoic acid receptor-α (RARA) gene at 17q21.1 and the promyelocytic leukemia (PML) gene at 15q24.1. Standard APL therapy is a combination of all-trans retinoic acid and anthracycline-based chemotherapy. Anthracycline treatment is associated with secondary clonal chromosomal aberrations that can lead to therapy-related secondary myeloid neoplasms. We present a pediatric case of relapsed APL coexistent with treatment-associated secondary myeloid neoplasm with t(11;19)(q23;p13.1).
Collapse
|
11
|
Sahoo RK, Kumar L, Kumar R, Sharma A. Acute promyelocytic leukemia relapsing into acute myeloid leukemia-M2 with normal cytogenetics. Indian J Med Paediatr Oncol 2014; 34:327-9. [PMID: 24604968 PMCID: PMC3932606 DOI: 10.4103/0971-5851.125261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The use of all trans-retinoic acid (ATRA) and combination chemotherapy has made acute promyelocytic leukemia (APL) a potentially curable leukemia. Late sequelae of the treatment of APL have therefore become an important consideration in the overall treatment strategy. We report a patient with APL who achieved complete clinical and molecular remission after treatment with daunorubicin and ATRA. Three years later, she developed acute myeloid leukemia (AML), M2 subtype without any evidence of relapse of the APL clone. Karyotypic analysis showed a normal female karyotype.
Collapse
Affiliation(s)
- Ranjit Kumar Sahoo
- Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Lalit Kumar
- Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Rajive Kumar
- Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Atul Sharma
- Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
12
|
Iland HJ, Wei A, Seymour JF. Have all-trans retinoic acid and arsenic trioxide replaced all-trans retinoic acid and anthracyclines in APL as standard of care. Best Pract Res Clin Haematol 2014; 27:39-52. [DOI: 10.1016/j.beha.2014.04.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
13
|
Park SH, Chi HS, Cho YU, Jang S, Park CJ, Lee JH. A case of therapy-related acute myeloid leukemia with a normal karyotype after sustained molecular complete remission of acute promyelocytic leukemia. Ann Lab Med 2013; 34:68-70. [PMID: 24422201 PMCID: PMC3885778 DOI: 10.3343/alm.2014.34.1.68] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 07/31/2013] [Accepted: 08/20/2013] [Indexed: 11/28/2022] Open
Affiliation(s)
- Sang Hyuk Park
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Hyun-Sook Chi
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Young-Uk Cho
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Seongsoo Jang
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Chan-Jeoung Park
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Je-Hwan Lee
- Department of Hematology, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| |
Collapse
|
14
|
Ojeda-Uribe M, Schneider A, Luquet I, Berceanu A, Cornillet-Lefebvre P, Jeandidier E, Lioure B, Ades L, Mauvieux L, Himberlin C. Therapy-related acute myeloid leukemia (t-AML) with poor-risk cytogenetics in two patients with persistent molecular complete remission of acute promyelocytic leukemia. Eur J Haematol 2012; 89:267-72. [DOI: 10.1111/j.1600-0609.2012.01805.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Mario Ojeda-Uribe
- Département d'Hématologie; Service d'Hématologie Clinique et Unité de Thérapie Cellulaire; Hôpital E. Muller; Mulhouse; France
| | | | | | - Ana Berceanu
- Département d'Oncologie-Hématologie; Hôpital Hautepierre; Strasbourg; France
| | | | | | - Bruno Lioure
- Département d'Oncologie-Hématologie; Hôpital Hautepierre; Strasbourg; France
| | - Lionel Ades
- Service d'Hématologie Clinique; CHU Avicenne; Assistance Publique-Hopitaux de Paris (AP-HP) Bobigny-Paris; France
| | | | | |
Collapse
|
15
|
Therapy-related myeloproliferative neoplasm with ETV6-PDGFRB rearrangement following treatment of acute promyelocytic leukemia. Ann Hematol 2011; 90:1477-9. [DOI: 10.1007/s00277-011-1188-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Accepted: 02/03/2011] [Indexed: 10/18/2022]
|