Acute promyelocytic leukemia following mitoxantrone as single agent for the treatment of multiple sclerosis

Two new cases of acute promyelocytic leukemia following mitoxantrone treatment in patients with multiple sclerosis

“…The occurrence of acute promyelocytic leukemia (APL) in MS patients treated with mitoxantrone has been well documented (Table 1). [2][3][4][5][6] We report two new cases of APL in MS patients following treatment with mitoxantrone.…”

Acute promyelocytic leukemia in a patient with multiple sclerosis following treatment with mitoxantrone

“…The incidence of APL following mitoxantrone therapy for MS is unknown, but appears to be extremely rare based on the available reports in the medical literature. 1,6,7 This case once again demonstrates the possible occurrence of APL following use of mitoxantrone in the treatment of MS. However, with the current therapeutic modalities, APL has become prognostically the most favorable subtype of AML and physicians should weigh these facts before deciding to use mitoxantrone in the treatment of MS. …”

“…3 Mitoxantrone has been used increasingly for the treatment of progressive MS, 4 but to the best of our knowledge only three cases have been reported so far regarding the development of APL in such a clinical scenario. 1,6,7 Our patient developed APL 11 months after completion of mitoxantrone therapy. Although the patient did receive one dose of intrathecal methotrexate, no occurrence of APL after a single intrathecal methotrexate has been documented to this date.…”

“…1 However, only a few cases of therapy-related acute promyelocytic leukemia (tAPL) following the treatment of MS have been reported. 1,6,7 We report a case of a patient with MS treated with mitoxantrone, who developed APL 11 months after completion of therapy. showed normal trilineage hematopoiesis without evidence of residual leukemic cells.…”

Immunosuppressive Agents in Multiple Sclerosis

“…41 Several additional case reports have been published. [42][43][44][45][46][47][48][49][50][51][52] Retrospectively, a relative risk of 0.21% was estimated. 48 Thus, it is strongly recommended that monitoring blood cell counts should be continued for at least five years after discontinuation of therapy.…”