title: Isolated central nervous system relapse in childhood acute promyelocytic leukemia.
abstract: Central nervous system (CNS) involvement is rare in acute promyelocytic leukemia (APL). The majority of CNS relapses occur in patients with hyperleukocytosis at presentation, and the optimal management of such patients is still controversial. We describe a 13-year-old boy with APL who developed an isolated CNS relapse after first-line treatment with all-trans retinoic acid and chemotherapy. A second remission was achieved with a regimen consisting of intrathecal chemotherapy, intravenous high-dose cytarabine, and oral 6-mercaptopurine. All-trans retinoic acid was avoided owing to severe complications during initial therapy. The patient remains in molecular remission at 9 months after autologous stem cell transplant. Prognostic factors of CNS relapse in children with APL are needed to define the indications for CNS prophylaxis in this group of patients.
authors: Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors: Katrin
authors: K
authors: Scheinemann
authors: Sheila
authors: S
authors: Weitzman
authors: Johann
authors: J
authors: Hitzler
authors: John
authors: J
authors: Doyle
authors: Oussama
authors: O
authors: Abla
mesh_terms: D000293:Adolescent; D016543:Central Nervous System Neoplasms / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy*; D008297:Male; D012008:Recurrence; D014212:Tretinoin / Q000627:therapeutic use
chemical_list: D014212:Tretinoin