All-trans-retinoic acid (ATRA) responsive skin relapses of acute promyelocytic leukaemia followed by ATRA-induced pseudotumour cerebri.
A 30-year-old woman with acute promyelocytic leukaemia (APL) went into complete remission following idarubicin and cytarabine chemotherapy; 18 months later she developed repeated skin relapse, with no bone marrow involvement. DNA and RNA analysis of skin lesions revealed the presence of the PML/RAR alpha hybrid gene, which was not detected at the same time in bone marrow. The skin relapses were successfully treated by all-trans-retinoic acid (ATRA) as single agent over 2 years. However, prolonged administration of ATRA caused pseudotumour cerebri, which disappeared upon drug withdrawal. The absence of the hybrid gene in the bone marrow by RT-PCR analysis led to the patient being autografted.
Selleri
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Divisione di Ematologia, Federico II university Medical School, Naples, Italy.
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Luciano
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Frigeri
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Salvatore
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D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001483:Base Sequence; D015139:Blotting, Southern; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy*; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D011559:Pseudotumor Cerebri / Q000139:chemically induced*; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D014212:Tretinoin / Q000009:adverse effects* / Q000627:therapeutic use
D003561:Cytarabine; D014212:Tretinoin; D015255:Idarubicin