title: Acquired acute myelogenous leukemia after therapy for acute promyelocytic leukemia with t(15;17): a case report and review of the literature.
abstract: Therapy-related myelodysplastic syndrome (t-MDS) and therapy-related acute myelogenous leukemia (t-AML) in patients with acute promyelocytic leukemia (APL) are rare events. The cumulative exposure to chemotherapy with alkylating agents and topoisomerase II inhibitors is associated with t-AML that may develop any time after the completion of the treatment. We report the case of an acquired AML who previously received therapy for APL, after two years of being diagnosed. The diagnosis was established by morphologic findings, membrane markers, cytogenetic studies, and fluorescence in situ hybridization (FISH). To our knowledge this is the first documented case in Puerto Rico of a patient with APL that developed a t-AML without the characteristic chromosomal and morphologic findings of APL.
authors.affiliation: Hematology-Oncology Section, University District Hospital, UPR School of Medicine, San Juan, Puerto Rico.
authors.forename: Rafael D
authors.initials: RD
authors.lastname: Betancourt-García
authors.forename: Justiniano
authors.initials: J
authors.lastname: Castro
authors.forename: Adry C
authors.initials: AC
authors.lastname: Fernández
authors.forename: Alberto
authors.initials: A
authors.lastname: López-Enríquez
authors.forename: Jean
authors.initials: J
authors.lastname: Fradera
authors.forename: Eileen
authors.initials: E
authors.lastname: Pacheco
mesh_terms: D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002884:Chromosomes, Human, Pair 15 / Q000648:ultrastructure; D002886:Chromosomes, Human, Pair 17 / Q000648:ultrastructure; D002891:Chromosomes, Human, Pair 21 / Q000648:ultrastructure; D002893:Chromosomes, Human, Pair 3 / Q000648:ultrastructure; D002897:Chromosomes, Human, Pair 7; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage / Q000009:adverse effects; D004357:Drug Synergism; D017809:Fatal Outcome; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000209:etiology* / Q000235:genetics; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy* / Q000235:genetics; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D008942:Mitoxantrone / Q000008:administration & dosage / Q000009:adverse effects; D009006:Monosomy; D016609:Neoplasms, Second Primary / Q000209:etiology* / Q000235:genetics; D014178:Translocation, Genetic; D014212:Tretinoin / Q000008:administration & dosage
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003561:Cytarabine; D014212:Tretinoin; D008942:Mitoxantrone; D015122:Mercaptopurine; D008727:Methotrexate; D003630:Daunorubicin