title: Acute promyelocytic leukemia with the translocation t(15;17)(q22;q21) associated with t(1;2)(q42~43;q11.2~12): a case report.
abstract: BACKGROUND
  Acute promyelocytic leukemia is characterized by a typical reciprocal translocation t(15;17)(q22;q21). Additional chromosomal abnormalities are reported in only 23-43 % of cases of acute promyelocytic leukemia.
  
  
  METHODS
  Here we report the case of a 46-year-old Syrian Alawis woman with acute promyelocytic leukemia with the typical t(15;17) translocation, but with a second clone presenting a t(1;2)(q42~43;q11.2~12) translocation as an additional abnormality. To the best of our knowledge, an association between these chromosomal abnormalities has not previously been described in the literature. Our patient started treatment with all-trans retinoic acid 10 days after diagnosis but died the same day of treatment initiation due to hemolysis, intracranial hemorrhage, thrombocytopenia, and disseminated intravascular coagulation.
  
  
  CONCLUSIONS
  The here reported combination of aberrations in a case of acute promyelocytic leukemia seems to indicate an adverse prognosis, and possibly shows that all-trans retinoic acid treatment may be contraindicated in such cases.
authors.affiliation: Human Genetics Division, Department of Molecular Biology and Biotechnology, PO Box 6091, Damascus, Syria.
authors.forename: Abdulsamad
authors.initials: A
authors.lastname: Wafa
authors.affiliation: Human Genetics Division, Department of Molecular Biology and Biotechnology, PO Box 6091, Damascus, Syria.
authors.forename: Faten
authors.initials: F
authors.lastname: Moassass
authors.affiliation: Institute of Human Genetics, Jena University Hospital, Kollegiengasse 10, D-07743, Jena, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Liehr
authors.affiliation: Human Genetics Division, Department of Molecular Biology and Biotechnology, PO Box 6091, Damascus, Syria.
authors.forename: Ayman
authors.initials: A
authors.lastname: Al-Ablog
authors.affiliation: Human Genetics Division, Department of Molecular Biology and Biotechnology, PO Box 6091, Damascus, Syria. ascientific@aec.org.sy.
authors.forename: Walid
authors.initials: W
authors.lastname: Al-Achkar
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D002884:Chromosomes, Human, Pair 15 / Q000235:genetics*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy / Q000235:genetics*; D008875:Middle Aged; D013593:Syria; D014178:Translocation, Genetic / Q000235:genetics*; D014212:Tretinoin / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D014212:Tretinoin
keywords: Acute myeloid leukemia (AML); Acute promyelocytic leukemia (APL); All-trans retinoic acid (ATRA); Prognostic factors; t(1;2)