title: Secondary acute promyelocytic leukemia following chemotherapy for gastric cancer: a case report.
abstract: Therapy-related acute myeloid leukemia (t-AML) refers to a heterogeneous group of myeloid neoplasms that develop in patients following extensive exposure to either cytotoxic agents or radiation. The development of t-AML has been reported following treatment of cancers ranging from hematological malignancies to solid tumors; however, to our knowledge, t-AML has never been reported following treatment of gastric cancer. In this study, we report the development of t-acute promyelocytic leukemia in a cT4N1M0 gastric cancer patient after an approximate 44 mo latency period following treatment with 4 cycles of oxaliplatin (OXP) (85 mg/m(2) on day 1) plus capecitabine (1250 mg/m(2) orally twice daily on days 1-14) in combination with recombinant human granulocyte-colony stimulating factor treatment. Karyotype analysis of the patient revealed 46,XY,t(15;17)(q22;q21)[15]/46,idem,-9,+add(9)(p22)[2]/46,XY[3], which, according to previous studies, includes some "favorable" genetic abnormalities. The patient was then treated with all-trans retinoic acid (ATRA, 25 mg/m(2)/d) plus arsenic trioxide (ATO, 10 mg/d) and attained complete remission. Our case illuminated the role of certain cytotoxic agents in the induction of t-AML following gastric cancer treatment. We recommend instituting a mandatory additional evaluation for patients undergoing these therapies in the future.
authors.affiliation: Ying-Cheng Zhang, Yu-Qi Zhou, Bing Yan, Jun Shi, Li-Juan Xiu, Yu-Wei Sun, Xuan Liu, Zhi-Feng Qin, Pin-Kang Wei, Yong-Jin Li, Department of Traditional Chinese Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Ying-Cheng
authors.initials: YC
authors.lastname: Zhang
authors.affiliation: Ying-Cheng Zhang, Yu-Qi Zhou, Bing Yan, Jun Shi, Li-Juan Xiu, Yu-Wei Sun, Xuan Liu, Zhi-Feng Qin, Pin-Kang Wei, Yong-Jin Li, Department of Traditional Chinese Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Yu-Qi
authors.initials: YQ
authors.lastname: Zhou
authors.affiliation: Ying-Cheng Zhang, Yu-Qi Zhou, Bing Yan, Jun Shi, Li-Juan Xiu, Yu-Wei Sun, Xuan Liu, Zhi-Feng Qin, Pin-Kang Wei, Yong-Jin Li, Department of Traditional Chinese Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Yan
authors.affiliation: Ying-Cheng Zhang, Yu-Qi Zhou, Bing Yan, Jun Shi, Li-Juan Xiu, Yu-Wei Sun, Xuan Liu, Zhi-Feng Qin, Pin-Kang Wei, Yong-Jin Li, Department of Traditional Chinese Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Shi
authors.affiliation: Ying-Cheng Zhang, Yu-Qi Zhou, Bing Yan, Jun Shi, Li-Juan Xiu, Yu-Wei Sun, Xuan Liu, Zhi-Feng Qin, Pin-Kang Wei, Yong-Jin Li, Department of Traditional Chinese Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Li-Juan
authors.initials: LJ
authors.lastname: Xiu
authors.affiliation: Ying-Cheng Zhang, Yu-Qi Zhou, Bing Yan, Jun Shi, Li-Juan Xiu, Yu-Wei Sun, Xuan Liu, Zhi-Feng Qin, Pin-Kang Wei, Yong-Jin Li, Department of Traditional Chinese Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Yu-Wei
authors.initials: YW
authors.lastname: Sun
authors.affiliation: Ying-Cheng Zhang, Yu-Qi Zhou, Bing Yan, Jun Shi, Li-Juan Xiu, Yu-Wei Sun, Xuan Liu, Zhi-Feng Qin, Pin-Kang Wei, Yong-Jin Li, Department of Traditional Chinese Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Xuan
authors.initials: X
authors.lastname: Liu
authors.affiliation: Ying-Cheng Zhang, Yu-Qi Zhou, Bing Yan, Jun Shi, Li-Juan Xiu, Yu-Wei Sun, Xuan Liu, Zhi-Feng Qin, Pin-Kang Wei, Yong-Jin Li, Department of Traditional Chinese Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Zhi-Feng
authors.initials: ZF
authors.lastname: Qin
authors.affiliation: Ying-Cheng Zhang, Yu-Qi Zhou, Bing Yan, Jun Shi, Li-Juan Xiu, Yu-Wei Sun, Xuan Liu, Zhi-Feng Qin, Pin-Kang Wei, Yong-Jin Li, Department of Traditional Chinese Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Pin-Kang
authors.initials: PK
authors.lastname: Wei
authors.affiliation: Ying-Cheng Zhang, Yu-Qi Zhou, Bing Yan, Jun Shi, Li-Juan Xiu, Yu-Wei Sun, Xuan Liu, Zhi-Feng Qin, Pin-Kang Wei, Yong-Jin Li, Department of Traditional Chinese Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Yong-Jin
authors.initials: YJ
authors.lastname: Li
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D014408:Biomarkers, Tumor / Q000235:genetics; D001706:Biopsy; D000069287:Capecitabine / Q000009:adverse effects; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects; D006801:Humans; D007621:Karyotyping; D015473:Leukemia, Promyelocytic, Acute / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics; D008297:Male; D009944:Organoplatinum Compounds / Q000009:adverse effects; D000077150:Oxaliplatin; D011237:Predictive Value of Tests; D012074:Remission Induction; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D016179:Granulocyte Colony-Stimulating Factor; D000069287:Capecitabine
keywords: Acute promyelocytic leukemia; Capecitabine; Chemotherapy; Gastric cancer; Oxaliplatin