Secondary myelodysplastic syndrome after treatment for promyelocytic leukemia: clinical and genetic features of two cases.
Acute promyelocytic leukemia (APL) represents a biologic and clinically well-defined subtype of acute nonlymphocytic leukemia with specific morphologic and karyotypic characteristics. Although secondary leukemia and myelodysplastic syndromes (MDS) are the most frequent secondary neoplasms following chemotherapy for acute leukemia, their development after complete remission in patients with APL is uncommon. We describe the clinical and genetic features of two APL patients who achieved CR after chemotherapy and all-trans retinoid acid treatment and subsequently developed a MDS. Therapy-related MDS karyotype changes such as abnormalities of chromosomes 5 and 7 were found in the cytogenetic analysis. Since TP53 alteration was detected in one case, possible implications of these findings in the onset of MDS are discussed.
Panizo
Carlos
C
Department of Hematology, University Clinic of Navarra, University of Navarra, Navarra, Spain. cpanizo@unav.es
Patiño
Ana
A
Lecumberri
Ramón
R
Calasanz
María José
MJ
Odero
María Dolores
MD
Bendandi
Maurizio
M
Rocha
Eduardo
E
D000368:Aged; D001483:Base Sequence; D005260:Female; D016161:Genes, Retinoblastoma / Q000235:genetics; D019942:Genes, p16; D016158:Genes, p53 / Q000235:genetics; D006801:Humans; D007621:Karyotyping; D015473:Leukemia, Promyelocytic, Acute / Q000150:complications* / Q000188:drug therapy* / Q000235:genetics; D019656:Loss of Heterozygosity; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000150:complications* / Q000235:genetics* / Q000473:pathology