title: Central nervous system involvement at the time of presentation in acute promyelocytic leukemia.
abstract: Central nervous system (CNS) involvement is rarely observed in acute promyelocytic leukemia (APML). Most cases of CNS involvement occur at relapse rather than at presentation. Because of the extremely low incidence of CNS disease, diagnostic lumbar puncture is not routinely required and prophylactic intrathecal chemotherapy is not routinely administered. Here, we describe a teenage patient with newly diagnosed APML, chloromas, and symptomatic CNS involvement confirmed by MRI and cerebrospinal fluid (CSF) findings.
authors.affiliation: Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana, USA. collins9@iupui.edu
authors.forename: Chelsea
authors.initials: C
authors.lastname: Collins
authors.forename: Holly
authors.initials: H
authors.lastname: Knoderer
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016543:Central Nervous System Neoplasms / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D017254:Leukemic Infiltration / Q000473:pathology* / Q000628:therapy; D015122:Mercaptopurine / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D011878:Radiotherapy; D023981:Sarcoma, Myeloid / Q000235:genetics / Q000473:pathology / Q000628:therapy; D014212:Tretinoin / Q000008:administration & dosage
chemical_list: D015514:Oncogene Proteins, Fusion; C093476:promyelocytic leukemia-retinoic acid receptor alpha fusion oncoprotein; D003561:Cytarabine; D014212:Tretinoin; D015122:Mercaptopurine; D008727:Methotrexate; D003630:Daunorubicin