Abstract
Central nervous system (CNS) involvement in acute promyelocytic leukemia (APL) is rare and tends to be seen mostly following treatment with all-trans retinoic acid (ATRA), due to prolonged patient survival and poor penetration of the drug in the CNS. At least 10% of extramedullary relapses in APL involve the CNS, and associated factors include an increased age, the BCR isoform, the development of differentiation syndrome, a high white cell count at presentation and hemorrhage into the CNS during induction therapy. We present the case of a patient with high-risk APL, CD56+, CD2+ in whom a CNS relapse was diagnosed through the presence of a PML/RARα rearrangement on PCR of the cerebrospinal fluid (CSF).
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Adult
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Antineoplastic Agents / therapeutic use
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CD56 Antigen / genetics
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CD56 Antigen / metabolism
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Central Nervous System Neoplasms / cerebrospinal fluid
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Central Nervous System Neoplasms / diagnosis*
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Central Nervous System Neoplasms / drug therapy
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Fatal Outcome
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Humans
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Leukemia, Promyelocytic, Acute / cerebrospinal fluid
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Leukemia, Promyelocytic, Acute / diagnosis*
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Leukemia, Promyelocytic, Acute / drug therapy
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Male
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Neoplasm Recurrence, Local / cerebrospinal fluid
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Neoplasm Recurrence, Local / drug therapy
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Neoplasm Recurrence, Local / pathology
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Oncogene Proteins, Fusion / cerebrospinal fluid*
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Oncogene Proteins, Fusion / genetics
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Polymerase Chain Reaction
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Tretinoin
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fms-Like Tyrosine Kinase 3 / genetics
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fms-Like Tyrosine Kinase 3 / metabolism
Substances
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Antineoplastic Agents
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CD56 Antigen
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Oncogene Proteins, Fusion
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promyelocytic leukemia-retinoic acid receptor alpha fusion oncoprotein
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Tretinoin
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FLT3 protein, human
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fms-Like Tyrosine Kinase 3