title: Clinical and pathologic features of secondary acute promyelocytic leukemia.
abstract: Acute promyelocytic leukemia (APL) is a relatively common form of acute myeloid leukemia (AML) that has an excellent prognosis. In contrast, secondary acute myeloid leukemias, including therapy-related AML and AML with myelodysplasia-related changes, have a relatively poor prognosis. We identified 9 cases of APL at our institution in which there was a history of chemotherapy, radiotherapy, chronic immunosuppression, or antecedent myelodysplastic syndrome. The clinical and pathologic findings in these cases of secondary APL were compared with the clinical and pathologic findings in cases of de novo APL. We found that secondary and de novo APL had abnormal promyelocytes with similar morphologic and immunophenotypic features, comparable cytogenetic findings, comparable rates of FMS-like tyrosine kinase mutations, and similar rates of recurrent disease and death. These data suggest that secondary APL is similar to de novo APL and, thus, should be considered distinct from other secondary acute myeloid neoplasms.
authors.affiliation: Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Amy S
authors.initials: AS
authors.lastname: Duffield
authors.forename: Joseph
authors.initials: J
authors.lastname: Aoki
authors.forename: Mark
authors.initials: M
authors.lastname: Levis
authors.forename: Kathleen
authors.initials: K
authors.lastname: Cowan
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Gocke
authors.forename: Kathleen H
authors.initials: KH
authors.lastname: Burns
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Borowitz
authors.forename: Milena
authors.initials: M
authors.lastname: Vuica-Ross
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism; D001854:Bone Marrow Cells / Q000378:metabolism / Q000473:pathology; D002869:Chromosome Aberrations; D003131:Combined Modality Therapy; D005260:Female; D005434:Flow Cytometry; D042381:Granulocyte Precursor Cells / Q000378:metabolism / Q000473:pathology; D006801:Humans; D016867:Immunocompromised Host; D016130:Immunophenotyping; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism / Q000401:mortality; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008875:Middle Aged; D009154:Mutation; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000188:drug therapy; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism / Q000401:mortality; D011379:Prognosis; D011505:Protein-Tyrosine Kinases / Q000235:genetics / Q000378:metabolism; D015996:Survival Rate; D055815:Young Adult
chemical_list: D015703:Antigens, CD; D014408:Biomarkers, Tumor; D011505:Protein-Tyrosine Kinases