急性髓系白血病复发时获得早幼粒细胞白血病-维甲酸受体α

Acute Myeloid Leukemia Acquiring Promyelocytic Leukemia-Retinoic Acid Receptor Alpha at Relapse.

作者信息

Gupta Varsha, Shariff Mohammed, Bajwa Ravneet, Patel Ishan, Ayyad Hashem A, Levitt Michael J, Mencel Peter J, Hossain Mohammad A

机构信息

Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, NJ, USA.

Department of Pathology, Jersey shore University Medical Center, Neptune, NJ, USA.

出版信息

World J Oncol. 2019 Jun;10(3):153-156. doi: 10.14740/wjon1211. Epub 2019 Jun 29.

DOI:10.14740/wjon1211

PMID:31312283

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6615911/

Abstract

Acute promyelocytic leukemia (APL) is identified as the M3 subtype of acute myeloid leukemia (AML). APL is presently one of the most curable leukemias. We describe here a rare case of APL who presented as a relapsed disease after 1 year of chemotherapy for AML. The patient lacked t(15;17) at the initial presentation but was present later at the time of relapse. The patient attained a complete remission following treatment with all-trans retinoic acid (ATRA) and arsenic trioxide-based therapy. We discuss the possible mechanism behind secondary acquisition of promyelocytic leukemia/retinoic acid receptor alpha (PML-RARA) at relapse of AML. We also briefly discuss the clinical features, diagnosis and treatment of APL.

摘要

急性早幼粒细胞白血病（APL）被确定为急性髓系白血病（AML）的M3亚型。APL目前是最可治愈的白血病之一。我们在此描述一例罕见的APL病例，该患者在接受AML化疗1年后出现复发疾病。患者初诊时缺乏t(15;17)，但在复发时出现。患者接受全反式维甲酸（ATRA）和基于三氧化二砷的治疗后达到完全缓解。我们讨论了AML复发时继发性获得早幼粒细胞白血病/维甲酸受体α（PML-RARA）背后的可能机制。我们还简要讨论了APL的临床特征、诊断和治疗。