Precursor T-lymphoblastic lymphoma as a secondary malignancy in a young patient after successful treatment of acute promyelocytic leukemia.
BACKGROUND
Acute promyelocytic leukemia (APL) is a relatively rare subtype of acute myeloid leukemia. It has become the best curable subtype of acute leukemias in adults due to the inclusion of all-trans-retinoic acid (ATRA) in the treatment. Despite the efficacy of ATRA, chemotherapy must be added in APL patients in order to maintain durable complete remission. However, chemotherapy administration is inevitably related to many complications, including the risk of secondary malignancies. T-lymphoblastic lymphoma (T-LBL) is an infrequent disease that belongs to the group of highly aggressive lymphomas.


METHODS
The authors describe the case of a 25-year-old woman who was treated for APL in 2002 and developed precursor T-LBL 5 years later.


CONCLUSIONS
Several cases of secondary acute lymphoblastic leukemias in 'cured' APL patients have been described, but probably no patient with secondary precursor T-LBL. Secondary malignancy has become one of the topics discussed (not only) in APL patients. It is apparently related to the excellent treatment outcomes and long-term survival. Better tailored treatment based on relevant prognostic factors allowing chemotherapy reduction or omission in some patients is needed.
Szotkowski
Tomas
T
Department of Hemato-Oncology, University Hospital Olomouc, Olomouc, Czech Republic. tszotkowski@seznam.cz
Jarosova
Marie
M
Faber
Edgar
E
Hubacek
Jaromir
J
Hlusi
Antonin
A
Papajik
Tomas
T
Pikalova
Zuzana
Z
Kucerova
Ladislava
L
Holzerova
Milena
M
Budikova
Miroslava
M
Buriankova
Eva
E
Plachy
Radek
R
Potomkova
Jarmila
J
Klusova
Natalie
N
Szotkowska
Romana
R
Indrak
Karel
K
D000328:Adult; D005260:Female; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000150:complications* / Q000628:therapy*; D054218:Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000209:etiology* / Q000517:prevention & control