open access

Vol 4, No 4 (2013)
Case report
Published online: 2014-02-06
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Secondary acute myeloid leukemia after successful treatment of acute promyelocytic leukemia

Agnieszka Wierzbowska, Ewa Wawrzyniak, Anna Szmigielska-Kapłon, Magdalena Czemerska, Olga Grzybowska-Izydorczyk, Konrad Stępka, Agnieszka Pluta, Tadeusz Robak
Hematologia 2013;4(4):358-362.

open access

Vol 4, No 4 (2013)
CASE REPORTS
Published online: 2014-02-06

Abstract

Clonal aberrations, leading to development of therapy-related myelodysplastic syndromes and secondary acute myeloid leukemias (s-AML), are present in 10% of patients treated previously for acute promyelocytic leukemia (APL). Most of them, especially monosomy 7, are associated with extremely poor prognosis. We present a case of 22-years-old female patient with APL diagnosed in 2008 who achieved complete cytogenetic and molecular remission after treatment according to PETHEMA protocol. Two years after the treatment was completed, s-AML with complex monosomal karyotype including monosomy 7 and t(3;21)(q26.2;q22) was diagnosed. Complete cytogenetic remission was achieved after 2 induction cycles and finally the allogeneic hematopoietic stem cell transplantation from HLA-matched related donor was performed. In the posttransplant period moderate chronic graft versus host disease was observed. Now, 15 months after transplantation, the patient is still in complete cytogenetic remission with 100% of donor chimerism. Presented case demonstrates diagnostic and therapeutic dilemma of s-AML in a patient with complete remission of APL.

Abstract

Clonal aberrations, leading to development of therapy-related myelodysplastic syndromes and secondary acute myeloid leukemias (s-AML), are present in 10% of patients treated previously for acute promyelocytic leukemia (APL). Most of them, especially monosomy 7, are associated with extremely poor prognosis. We present a case of 22-years-old female patient with APL diagnosed in 2008 who achieved complete cytogenetic and molecular remission after treatment according to PETHEMA protocol. Two years after the treatment was completed, s-AML with complex monosomal karyotype including monosomy 7 and t(3;21)(q26.2;q22) was diagnosed. Complete cytogenetic remission was achieved after 2 induction cycles and finally the allogeneic hematopoietic stem cell transplantation from HLA-matched related donor was performed. In the posttransplant period moderate chronic graft versus host disease was observed. Now, 15 months after transplantation, the patient is still in complete cytogenetic remission with 100% of donor chimerism. Presented case demonstrates diagnostic and therapeutic dilemma of s-AML in a patient with complete remission of APL.

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Keywords

acute promyelocytic leukemia, secondary acute myeloid leukemia, monosomal karyotype, allogeneic hematopoietic stem cell transplantation

About this article
Title

Secondary acute myeloid leukemia after successful treatment of acute promyelocytic leukemia

Journal

Hematology in Clinical Practice

Issue

Vol 4, No 4 (2013)

Article type

Case report

Pages

358-362

Published online

2014-02-06

Bibliographic record

Hematologia 2013;4(4):358-362.

Keywords

acute promyelocytic leukemia
secondary acute myeloid leukemia
monosomal karyotype
allogeneic hematopoietic stem cell transplantation

Authors

Agnieszka Wierzbowska
Ewa Wawrzyniak
Anna Szmigielska-Kapłon
Magdalena Czemerska
Olga Grzybowska-Izydorczyk
Konrad Stępka
Agnieszka Pluta
Tadeusz Robak

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