International Journal of Hematology-Oncology and Stem Cell Research 2015. 9(4):215-217.

Treatment related acute promyelocytic leukemia (t-APML) in breast cancer survivor treated with anthracycline based chemotherapy: rare case report
Irappa Madabhavi, Gaurang Modi, Harsha Panchal, Apurva Patel, Asha Anand, Sonia Parikh

Abstract


Treatment related acute myeloid leukemia (t-AML) is well documented phenomenon after chemotherapy. In this subgroup of patients acute promyelocytic leukemia (APML) due to delayed complication of using anthracycline is very rare occurrence. Very few cases are reported in world literature. We are reporting a rare case of occurrence of t-APML in cured breast cancer patient treated with doxorubicin. 43 year old female presented with triple negative early breast cancer treated initially with Right modified radical mastectomy. Pathological staging was pT2N0M0. She was treated with 6 cycle of adjuvant AC (Doxorubicin, Cyclophosphamide). After latent period of 23 months she developed symptoms of fever, weakness and generalized body ache. On further investigation she was found to have acute promyelocytic leukemia (APML). We had successfully treated t-APML with conventional 7+3 induction and subsequent consolidation with ATRA (All Trans Retinoic Acid) and arsenic trioxide. Patient was given maintenance treatment for 18 months after confirming negative PML RARA by RT PCR and declared cured. Patient is under regular surveillance in our centre.


Keywords


Anthracycline; Breast cancer; t-APML

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References


Pulsoni A, Pagano L, Lo Coco F, et al. Clinicobiological features and outcome of acute promyelocytic leukaemia occurring as a second tumour: the GIMEMA experience. Blood. 2002; 100(6):1972-6.

Beaumont M, Sanz M, Carli PM, et al. Therapy-related acute promyelocytic leukaemia. J Clin Oncol. 2003; 21(11):2123-37.

Mistry AR, Felix CA, Whitmarsh RJ, et al. DNA topoisomerase II in therapy-related acute promyelocytic leukaemia. N Engl J Med. 2005; 352(15):1529-38.

Dayyani F, Kantarjian H, O'Brien S, et al. Outcome of therapy-related acute promyelocytic leukaemia with or without arsenic trioxide as a component of frontline therapy. Cancer. 2011; 117(1):110-5.

Le Deley MC, Leblanc T, Shamsaldin A, et al. Risk of Secondary Leukemia after a Solid Tumour in Childhood According to the Dose of Epipodophyllotoxins and Anthracyclines. J Clin Oncol. 2003; 21:1074-1081.

Hu J, Liu YF, Wu CF, et al. Long-term efficacy and safety of all-trans retinoic acid/arsenic trioxide-based therapy in newly diagnosed acute promyelocytic leukaemia. Proc Natl Acad Sci USA. 2009; 106 (9):3342-7.


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