title: Extramedullary relapse in a patient with acute promyelocytic leukemia: successful treatment with arsenic trioxide, all-trans retinoic acid and gemtuzumab ozogamicin therapies.
abstract: Acute promyelocytic leukemia (APL) is characterized by the presence of the t(15;17) translocation, resulting in the PML-RAR fusion protein. Standard treatment consists of the combination of all-trans retinoic acid (ATRA) with an anthracycline that results in complete remission (CR) rates in excess of 90%. Recently, several new agents have been shown to have clinical activity in APL. These include a liposomal formulation of ATRA (lipo-ATRA), and gemtuzumab ozogamicin (GO). Herein, we report a patient with APL who relapsed with extramedullary disease 2.5 years after lipo-ATRA therapy and was successfully treated with the sequence of A2O3, ATRA, and GO and we summarize our experience with patients with isolated extramedullary relapse in APL.
authors.affiliation: Department of Leukemia, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Box 428, Houston 77030, USA.
authors.forename: Apostolia-Maria
authors.initials: AM
authors.lastname: Tsimberidou
authors.forename: Elihu
authors.initials: E
authors.lastname: Estey
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Whitman
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Dryden
authors.forename: Suresh
authors.initials: S
authors.lastname: Ratnam
authors.forename: Sherry
authors.initials: S
authors.lastname: Pierce
authors.forename: Stefan
authors.initials: S
authors.lastname: Faderl
authors.forename: Francis
authors.initials: F
authors.lastname: Giles
authors.forename: Hagop M
authors.initials: HM
authors.lastname: Kantarjian
authors.forename: Guillermo
authors.initials: G
authors.lastname: Garcia-Manero
mesh_terms: D000617:Aminoglycosides / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D005260:Female; D000079982:Gemtuzumab; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy*; D017254:Leukemic Infiltration; D008875:Middle Aged; D010087:Oxides / Q000627:therapeutic use; D012008:Recurrence; D014212:Tretinoin / Q000627:therapeutic use
chemical_list: D000617:Aminoglycosides; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001152:Arsenicals; D010087:Oxides; D014212:Tretinoin; D000079982:Gemtuzumab; D000077237:Arsenic Trioxide