Myelodysplasia-related acute myeloid leukemia and acute promyelocytic leukemia: concomitant occurrence of two molecularly distinct diseases

Abstract

Concurrent presentation of acute promyelocytic leukemia (APL) with other hematologic diseases in the absence of previous chemotherapy or ionizing radiotherapy treatment is very rare. We present a case of simultaneous occurrence of APL with myelodysplastic syndrome (MDS)-related acute myeloid leukemia (AML). A 43-yearold female presented with 3 month of history fatigue, night sweats, chills and pancytopenia. Bone marrow aspirate and biopsy demonstrated 20% myeloid blasts with dysplastic changes admixed with abnormal promyelocytes. Cytogenetic analysis showed tetraploidy and deletion in chromosomes 5q and 7q and polymerase chain reaction showed presence of PML/RARA mRNA transcripts, confirming the presence of concurrent APL and MDS-related AML. Induction chemotherapy with cytarabine and daunorubicin was initiated along with all-trans retinoic acid. This is the first case to be reported in the literature of concurrent occurrence of APL with MDS-related AML. Treatment with 7 + 3 regimen and ATRA was successful in inducing complete remission.

Nuclear Lipid Microdomains Regulate Daunorubicin Resistance in Hepatoma Cells

“…Considerable research has implicated DNR as an anti-cancer drug [1,3,4,5,6,7]. Previously, we reported that DNR delayed lymphoma cell growth and high levels of CHO induced DNR-resistance [2].…”

“…Recently, liposomal cytarabine-daunorubicin CPX-351 has been approved as a new drug for treating acute myeloid leukemia [5]. The use of DNR combined with cytarabine and trans retinoic acid was able to induce complete remission of concomitant myelodysplasia-related acute myeloid leukemia and acute promyelocytic leukemia in a 43-year old patient [6]. A promising cancer therapy has been developed endocapsuling DNR in injectable polymeric nanocontainers [7].…”