Could ATRA/Idarubicin treatment of acute promyelocytic leukemia induce the appearance of new clonal cytogenetic abnormalities in patients in complete remission?

Mallo, Mar; Salido, Marta; Espinet, Blanca; Cervera, José; Canellas, Anna; Pajuelo, Juan C.; Pedro, Carmen; Florensa, Lourdes; Sanz, Miguel Á.; Solé, Françesc

doi:10.1016/j.leukres.2006.10.003

Cited by 2 publications

(2 citation statements)

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“…A similar theory has been proposed by those studying secondary, unrelated clones in treated CML patients [19,21]. A recent paper which identified a del(20q) in a patient during remission for APL, reported FISH testing for 20q deletion performed retrospectively on the initial diagnostic APL sample and at CR1, but did not detect a deletion by FISH [24]. Hence, if the theory of a ''suppressed clone'' holds true, it must be present in a very small proportion of cells.…”

Section: Discussionsupporting

confidence: 54%

Secondary clonal cytogenetic abnormalities following successful treatment of acute promyelocytic leukemia

Batzios

Hayes

et al. 2009

American J Hematol

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To identify patients who developed secondary clonal cytogenetic aberrations (CCA) following therapy for acute promyelocytic leukemia (APL), we retrospectively analyzed cytogenetic results from 123 patients diagnosed with APL between 1995 and 2007, who had ongoing cytogenetic analysis undertaken in our laboratory. During follow-up for APL we identified 12 patients (9.8%) who developed CCA, not detected at diagnosis of APL and unrelated to their original APL karyotype. All patients had received all-trans retinoic acid (ATRA) and chemotherapy and were in complete remission for APL when secondary CCA were identified. The median latency period between diagnosis of APL and emergence of secondary CCA was 27.5 months (range: 2-54 months). To date, four patients with CCA have been diagnosed with therapy-related myelodysplastic syndrome (t-MDS)/acute myeloid leukemia (t-AML), giving a median t-MDS/AML free survival of 78 months, with follow-up ranging between 20 and 136 months from APL diagnosis. Three patients have died: two patients died of t-AML and another developed relapsed APL with persistence of his secondary clone but no diagnosis of t-MDS/AML and died from transplant-related complications. Two patients are alive with t-MDS. Seven patients with CCA are alive with no morphological evidence of MDS at the time of their last known follow-up; thus median survival has not been reached. The appearance of these abnormalities in the absence of morphological evidence of MDS in the majority of patients is unusual, and highlights the importance of continued cytogenetic follow-up in these patients. Am. J. Hematol., 2009. (c) 2009 Wiley-Liss, Inc.

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Section: Discussionsupporting

confidence: 54%

Secondary clonal cytogenetic abnormalities following successful treatment of acute promyelocytic leukemia

Batzios

Hayes

et al. 2009

American J Hematol

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“…We describe two patients who developed distinct AML clones without t(15;17) following treatment for APL. Such secondary clonal hematologic neoplasia occurring after successful therapy for APL is rare but has been documented, and these cases are illustrated in Table 1 [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] . Frequencies ranging from 1–9.8% [18] , [20] , [29] , [33] have been reported with a median latency period of 35.6 months (range 1–158 months) after remission of APL.…”

Section: Discussionmentioning

confidence: 99%

Secondary clonal hematologic neoplasia following successful therapy for acute promyelocytic leukemia (APL): A report of two cases and review of the literature

Gaut

Sasine

Schiller

2018

Leukemia Research Reports

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Although rare, secondary clonal hematologic neoplasia may occur after successful therapy for acute promyelocytic leukemia (APL). These secondary clonal events may be considered therapy-related, but may also be due to an underlying background of clonal hematopoiesis from which both malignancies may develop. In this manuscript, we describe two patients with secondary clones after APL therapy characterized in one patient by deletion of chromosome 11q23 and, in the other, by monosomy of chromosome 7, and also provide a review of all secondary clonal disorders described after APL therapy. We suggest that since most reports identify karyotypic abnormalities not typically associated with chemotherapy, there may be another mechanism underlying secondary clonal development after complete response to initial APL therapy.

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Could ATRA/Idarubicin treatment of acute promyelocytic leukemia induce the appearance of new clonal cytogenetic abnormalities in patients in complete remission?

Cited by 2 publications

References 6 publications

Secondary clonal cytogenetic abnormalities following successful treatment of acute promyelocytic leukemia

Secondary clonal cytogenetic abnormalities following successful treatment of acute promyelocytic leukemia

Secondary clonal hematologic neoplasia following successful therapy for acute promyelocytic leukemia (APL): A report of two cases and review of the literature

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