title: Relapse in the external auditory canal of acute promyelocytic leukemia after treatment with all-trans retinoic acid.
abstract: A 54-year-old female was admitted to our hospital for gingival bleeding and was diagnosed as acute promyelocytic leukemia (APL). She received induction therapy according to the AML92 protocol of the Japan Adult Leukemia Study Group (JALSG) with all-trans retinoic acid (ATRA) plus chemotherapeutic agents. She achieved complete remission, but one year later had a relapse in her external auditory canal without leukemic cell in the bone marrow. Extramedullary disease is rare in APL. This case suggests the importance of careful observation for extramedullary relapse in patients who are treated with ATRA.
authors.affiliation: Department of Medicine III, Hamamatsu University School of Medicine, Handa-cho.
authors.forename: T
authors.initials: T
authors.lastname: Tobita
authors.forename: K
authors.initials: K
authors.lastname: Shinjyo
authors.forename: M
authors.initials: M
authors.lastname: Yanagi
authors.forename: A
authors.initials: A
authors.lastname: Takeshita
authors.forename: K
authors.initials: K
authors.lastname: Ohnishi
authors.forename: R
authors.initials: R
authors.lastname: Ohno
mesh_terms: D000380:Agranulocytosis / Q000139:chemically induced / Q000188:drug therapy; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage / Q000031:analogs & derivatives; D003630:Daunorubicin / Q000008:administration & dosage; D004424:Ear Canal; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D015122:Mercaptopurine / Q000008:administration & dosage; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D009363:Neoplasm Proteins / Q000032:analysis; D015514:Oncogene Proteins, Fusion / Q000032:analysis; D011878:Radiotherapy; D012008:Recurrence; D012074:Remission Induction; D016879:Salvage Therapy; D014212:Tretinoin / Q000008:administration & dosage; D014751:Vindesine / Q000008:administration & dosage
chemical_list: D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D015514:Oncogene Proteins, Fusion; C093476:promyelocytic leukemia-retinoic acid receptor alpha fusion oncoprotein; D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D014212:Tretinoin; C015019:enocitabine; D008942:Mitoxantrone; D015122:Mercaptopurine; D014751:Vindesine; D015255:Idarubicin; D003630:Daunorubicin