Skip to main content

Advertisement

SpringerLink
Log in

Chronic Myeloid Leukemia Developing After Successful Treatment of Acute Promyelocytic Leukemia

  • Case Report
  • Published:
Indian Journal of Hematology and Blood Transfusion Aims and scope Submit manuscript

Abstract

Acute promyelocytic leukemia (APL) has been regarded as a highly curable disease. Therapy-related leukemia is one of the important late complications that affect long-term survival rates in APL patients. Therapy-related acute myeloid leukemia and myelodysplastic syndrome are the major forms of therapy-related leukemias. We report a rare event of chronic myeloid leukemia (CML) that developed after successful treatment of APL with all-trans-retinoic acid in combination with chemotherapy. Rather unexpectedly, CML developed 7 years after APL. Cytogenetic and molecular studies proved the independence of these two entities. It was found that CML progressed rapidly after a short-term response to a combination therapy with hydroxyurea, interferon-α and arsenic trioxide. We propose that optimization of chemotherapy regimen and treatment intensity may reduce the risk of developing a secondary leukemia, while long-term monitoring cytogenetics of APL patients after treatment may help determine the development of a secondary leukemia at early stage.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

References

  1. Zompi S, Viguie F (2002) Therapy-related acute myeloid leukemia and myelodysplasia after successful treatment of acute promyelocytic leukemia. Leuk Lymphoma 43:275–280

    Article  PubMed  Google Scholar 

  2. Lobe I, Rigal-Huguet F, Vekhoff A, Desablens B, Bordessoule D, Mounier C, Ferrant A, Sanz M, Fey M, Chomienne C, Chevret S, Degos L, Fenaux P, European APL Group Experience (2003) Myelodysplastic syndrome after acute promyelocytic leukemia: the European APL Group Experience. Leukemia 17:1600–1604

    Article  CAS  PubMed  Google Scholar 

  3. Latagliata R, Petti MC, Fenu S, Mancini M, Spiriti MA, Breccia M, Brunetti GA, Avvisati G, Lo Coco F, Mandelli F (2002) Therapy-related myelodysplastic syndrome-acute myelogenous leukemia in patients treated for acute promyelocytic leukemia: an emerging problem. Blood 99:822–824

    Article  CAS  PubMed  Google Scholar 

  4. Leone G, Pagano L, Ben-Yehuda D, Voso MT (2007) Therapy-related leukemia and myelodysplasia: susceptibility and incidence. Haematologica 92:1389–1398

    Article  CAS  PubMed  Google Scholar 

  5. Aguiar RC (1998) Therapy-related chronic myeloid leukemia: an epidemiological, clinical and pathogenetic appraisal. Leuk Lymphoma 29:17–26

    Article  CAS  PubMed  Google Scholar 

  6. Bauduer F, Ducout L, Dastugue N, Marolleau JP (2002) Chronic myeloid leukemia as a secondary neoplasm after anti-cancer radiotherapy: a report of three cases and a brief review of the literature. Leuk Lymphoma 43:1057–1060

    Article  PubMed  Google Scholar 

  7. Waller CF, Fetscher S, Lange W (1999) Treatment-related chronic myelogenous leukemia. Ann Hematol 78:341–354

    Article  CAS  PubMed  Google Scholar 

  8. Ramanarayanan J, Dunford LM, Baer MR, Sait SN, Lawrence W, McCarthy PL (2006) Chronic myeloid leukemia after treatment of lymphoid malignancies: response to imatinib mesylate and favorable outcomes in three patients. Leuk Res 30:701–705

    Article  CAS  PubMed  Google Scholar 

  9. Sakamaki H, Nakamura S, Maruyama Y, Nagata K, Yahara Y, Onozawa Y (1989) Chronic myelocytic leukemia following chemotherapy of acute promyelocytic leukemia. Rinsho Ketsueki 30:1975–1981

    CAS  PubMed  Google Scholar 

  10. Imagawa J, Harada Y, Shimomura T, Tanaka H, Okikawa Y, Hyodo H, Kimura A, Harada H (2010) Clinical and genetic features of therapy-related myeloid neoplasms after chemotherapy for acute promyelocytic leukemia. Blood 116:6018–6022

    Article  CAS  PubMed  Google Scholar 

  11. Asou N, Kishimoto Y, Kiyoi H, Okada M, Kawai Y, Tsuzuki M, Horikawa K, Matsuda M, Shinagawa K, Kobayashi T, Ohtake S, Nishimura M, Takahashi M, Yagasaki F, Takeshita A, Kimura Y, Iwanaga M, Naoe T, Ohno R, Japan Adult Leukemia Study Group (2007) A randomized study with or without intensified maintenance chemotherapy in patients with acute promyelocytic leukemia who have become negative for PML-RARalpha transcript after consolidation therapy: the Japan Adult Leukemia Study Group (JALSG) APL97 study. Blood 110:59–66

    Article  CAS  PubMed  Google Scholar 

  12. Montesinos P, González JD, González J, Rayón C, de Lisa E, Amigo ML, Ossenkoppele GJ, Peñarrubia MJ, Pérez-Encinas M, Bergua J, Debén G, Sayas MJ, de la Serna J, Ribera JM, Bueno J, Milone G, Rivas C, Brunet S, Löwenberg B, Sanz M (2010) Therapy-related myeloid neoplasms in patients with acute promyelocytic leukemia treated with all-trans-retinoic acid and anthracycline-based chemotherapy. J Clin Oncol 28:3872–3879

    Article  CAS  PubMed  Google Scholar 

  13. Hu J, Liu YF, Wu CF, Xu F, Shen ZX, Zhu YM, Li JM, Tang W, Zhao WL, Wu W, Sun HP, Chen QS, Chen B, Zhou GB, Zelent A, Waxman S, Wang ZY, Chen SJ, Chen Z (2009) Long-term efficacy and safety of all-trans retinoic acid/arsenic trioxide-based therapy in newly diagnosed acute promyelocytic leukemia. Proc Natl Acad Sci USA 106(9):3342–3347

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Au WY, Kumana CR, Lam CW, Cheng VC, Shek TW, Chan EY, Liu R, Kwong YL (2007) Solid tumors subsequent to arsenic trioxide treatment for acute promyelocytic leukemia. Leuk Res 31:105–108

    Article  CAS  PubMed  Google Scholar 

  15. Bao L, Lu X, Lai Y, Zhang X, Zhu H, Liu Y, Qin Y, Huang XJ (2009) Therapy-related acute myeloid leukemia after successful therapy for acute promyelocytic leukemia with t(15;17): a case report and literature review. Leuk Res 33:e64–e68

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical statement

Informed consent for the collection of medical information for research and publication was obtained from the patient.

Author information

Authors and Affiliations

  1. Department of Hematology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665 Kongjiang Rd., Shanghai, 200092, People’s Republic of China

    Fang Huang, Jun Chang, Chao Du & Rong Tao

Authors
  1. Fang Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jun Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chao Du
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rong Tao
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rong Tao.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Huang, F., Chang, J., Du, C. et al. Chronic Myeloid Leukemia Developing After Successful Treatment of Acute Promyelocytic Leukemia. Indian J Hematol Blood Transfus 32 (Suppl 1), 104–107 (2016). https://doi.org/10.1007/s12288-015-0544-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12288-015-0544-z

Keywords

Search

Navigation