Acute promyelocytic leukemia after renal transplant and filgrastim treatment for neutropenia.
Prolonged immunosuppression in solid organ transplant recipients has been considered a risk for developing opportunistic infections and malignancies. Acute leukemia is a rare complication. We report a case of acute promyelocytic leukemia (APL) (FAB M3) after cadaveric renal transplant for focal segmental glomerulosclerosis in a 24-year-old woman. Her immunosuppressive therapy included tacrolimus, mycophenolate mofetil, and prednisone. Approximately 2 years after transplant, she became pancytopenic, prompting administration of filgrastim. A few doses caused a markedly increased blast count, resulting in a diagnosis of APL. She was successfully treated with all-trans-retinoic acid and arsenic trioxide. Myeloproliferative neoplasms after organ transplant or due to filgrastim are rare.
Division of Hematopathology, Department of Pathology, Baylor University Medical Center at Dallas and the Charles A. Sammons Cancer Center at Dallas, Texas.
Jaime A
JA
Campbell
Division of Hematopathology, Department of Pathology, Baylor University Medical Center at Dallas and the Charles A. Sammons Cancer Center at Dallas, Texas.
John R
JR
Krause
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