Open AccessAcute promyelocytic leukemia with myelofibrosis
Author(s) -
Man Xiao,
Ling Qin,
Xiaofei Niu,
Pan Zhou,
Junwei Niu,
Shengjie Wei,
Dan Li,
Liurui Dou,
Wanjun Zhang,
Lei Zhang,
Kai Sun,
Yanliang Bai
Publication year - 2021
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000024567
Subject(s) - medicine , acute promyelocytic leukemia , myelofibrosis , arsenic trioxide , bone marrow , biopsy , gastroenterology , surgery , retinoic acid , apoptosis , biochemistry , chemistry , gene
Rationale: Acute promyelocytic leukemia (APL) with myelofibrosis (MF) is rare, and only 14 cases have been reported in the literature to date. Patient concerns: A 42-year-old woman was admitted to the hospital with easy bruising and excessive bleeding. With the remission of the primary disease during treatment, the degree of fibrosis did not decrease, but worsened progressively. Diagnosis: The woman was diagnosed with acute promyelocytic leukemia with secondary myelofibrosis. Interventions: All-trans retinoic acid (ATRA) was discontinued after 6 months of complete remission of APL. Arsenic trioxide (ATO) was discontinued because of supraventricular tachycardia 9 months after complete remission of APL. Outcomes: After withdrawal of ATRA for 2 months, the degree of fibrosis was significantly alleviated, and after withdrawal of ATRA for 8 months and ATO for 5 months, bone marrow biopsy showed no reticular fiber deposition. Lessons: In this case report and review of an additional 14 cases of APL with MF, we highlighted the importance of the degree of MF to be evaluated by bone marrow biopsy at the time of bone marrow aspiration when APL is suspected. If MF is present, the type of MF should be determined in a timely manner, and appropriate intervention measures should be taken accordingly.