Acute promyelocytic leukemia with a smoldering course associated with therapy-related myelodysplastic syndrome

Ofir Wolach*, Moshe Yeshurun, Ninette Amariglio, Ofer Shpilberg, Pia Raanani

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Acute promyelocytic leukemia (APL) may appear rarely as a late complication of the treatment of other primary cancers. Therapy-related APL (tAPL) differs from de novo APL in epidemiological and clinical parameters but shares common molecular signatures and does not differ in survival end- points. We describe a 67-year-old female patient who presented with an atypical course of tAPL. Atypical features in this patient's course included a preceding therapy-related myelodysplastic syndrome (MDS) with a slowly expanding pathological promyelocyte clone. Following treatment with all-trans-retinoic acid and arsenic trioxide, the patient achieved complete clinical, morphological and molecular remission. Review of the pertinent literature highlights the rarity of MDS transforming into APL, although dysplasia has been shown to be a possible feature of tAPL. MDS may be an underdiagnosed stage in tAPL leukomogenesis. This case also underscores the complexity of clinical decision-making in the context of tAPL.

Original languageEnglish
Pages (from-to)152-156
Number of pages5
JournalActa Haematologica
Volume126
Issue number3
DOIs
StatePublished - Sep 2011

Keywords

  • Acute promyelocytic leukemia
  • Myelodysplastic syndrome
  • Secondary leukemia

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