Acute promyelocytic leukemic involvement of the optic nerves following mitoxantrone treatment for multiple sclerosis.
Mitoxantrone, the first immunosuppressant to receive FDA approval for treatment of worsening relapsing-remitting, secondary progressive, and progressive-relapsing multiple sclerosis (MS) is a DNA topoisomerase II inhibitor that has been associated with the development of acute promyelocytic myelogenous leukemia (APML). Central nervous system APML is a rare site of extramedullary involvement following mitoxantrone therapy. We report a patient with history of multiple sclerosis who developed bilateral optic nerve involvement as the primary manifestation of APML relapse following mitoxantrone treatment.
Ko
Melissa W
MW
Department of Neurology, State University of New York Upstate Medical University, Syracuse, NY, United States. kom@upstate.edu
Tamhankar
Madhura A
MA
Volpe
Nicholas J
NJ
Porter
David
D
McGrath
Cindy
C
Galetta
Steven L
SL
D000700:Analgesics / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000139:chemically induced* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D008942:Mitoxantrone / Q000009:adverse effects*; D009103:Multiple Sclerosis / Q000188:drug therapy; D009900:Optic Nerve / Q000187:drug effects* / Q000503:physiopathology
D000700:Analgesics; D008942:Mitoxantrone