 |
|
- Main page
- News
- RJLabM Credits
- Archive
- Instructions for authors
- Online applications
- Editorial
- About us
-
Links
- Committee on Publication Ethics (COPE)
- International Committee of Medical Journal Editors
- Acta Marisiensis Seria Medica
- Bacteriologia, Virusologia, Parazitologia, Epidemiologia
- Biochemia Medica
- Clinical Chemistry and Laboratory Medicine
- Clinical Chemistry
- Clinica Chimica Acta
- Documenta Haematologica
- Romanian Journal of Morphology and Embryology
- Biostatistics and web search strategies (Romanian)
- How to spot a statistical problem
- Statistical Analyses and Methods in the Published Literature
ISSN online: 2284-5623
ISSN-L: 1841-6624
Rejection rate (2020): 75%
Journal Metrics
Impact Factor 0.5 Five Year Impact Factor 0.5 JCI 0.12
Log in
Concept, Design & Programming
Dr. Adrian Man
Case report Therapy-related myelodysplastic syndrome after successful treatment of acute promyelocytic leukemia: case report and literature review Mihaela Cîrstea, Adriana Coliță, Bogdan Ionescu, Alexandra Ghiaur, Didona Vasilescu, Camelia Dobrea, Cerasela Jardan, Mihaela Dragomir, Anca Gheorghe, Zsofia Várady, Anca Roxana Lupu, Daniel Coriu
Correspondence should be addressed to: Mihaela Cîrstea
Abstract: In the 2016 revision of the World Health Organization classification the term therapy-related myeloid neoplasia (t-MN) defines a subgroup of acute myeloid leukemia (AML) comprising patients who develop myelodysplastic syndrome (MDS-t) or acute myeloid leukemia (AML-t) after treatment with cytotoxic and/or radiation therapy for various malignancies or autoimmune disorders. We report the case of a 36 year old patient with t-MN (t-MDS) after achieving complete remission (CR) of a PML-RARA positive acute promyelocytic leukemia (APL) at 32 months after diagnosis. Initially classified as low risk APL and treated according to the AIDA protocol - induction and 3 consolidation cycles - the patient achieved a complete molecular response in September 2013 and started maintenance therapy. On follow-up PML-RARA transcript remained negative. In January 2016 leukopenia and thrombocytopenia developed and a peripheral blood smear revealed hypogranular and agranular neutrophils. Immunophenotyping in the bone marrow aspirate identified undifferentiated blast cells that did not express cytoplasmic myeloperoxidase. The cytogenetic study showed normal karyotype. The molecular biology tests not identified PML-RARA transcript. A diagnosis of t-MDS (AREB-2 - WHO 2008) was established. Treatment of AML was started with 2 “3+7” regimens and 1 MEC cycle. Two months from diagnosis, while in CR, an allogeneic HSCT from an unrelated HLA compatible donor was performed after myeloablative regimen. An unfavorable clinical evolution was followed by death on day 9 after transplantation. The occurrence of t-MNs during CR of APL represents a particular problem in terms of follow-up and differential diagnosis of relapse and constitutes a dramatic complication for a disease with a favorable prognosis. This work was supported by the grants PN 41-087 /PN2-099 from the Romanian Ministry of Research and Technology. Keywords: acute promyelocytic leukemia, therapy-related myeloid neoplasms, allogeneic hematopoietic stem cell transplantation
Received: 19.1.2017 |
|||||
|
Download full text PDF (714 KB) |
||||
|
Cîrstea M, Coliță A, Ionescu B, Ghiaur A, Vasilescu D, Dobrea C, et al. Therapy-related myelodysplastic syndrome after successful treatment of acute promyelocytic leukemia: case report and literature review. Rev Romana Med Lab. 2017;25(2):165-79. DOI:10.1515/rrlm-2017-0013
|
|||||