[Acute Promyelocytic Leukemia Developed during Imatinib Therapy for Gastrointestinal Stromal Tumors].

Abstract

OBJECTIVE:

To investigate the clinicopathologic and molecular characteristics of acute promyelocytic leukemia(APL) developed during imatinib therapy for gastrointestinal stromal tumors(GIST).

METHODS:

A 49-year-old woman was hospitalized for abdominal pain. The abdominal CT revealed a gastric mass. Laparoscopic resection of the tumor was performed. The histopathologic analysis showed poorly differentiated malignant cell infiltration with epithelioid features. Immunohistochemistry staining of these cells was positive for CD117 and CD34. GIST was confirmed and imatinib treatment was given.

RESULTS:

After 1 year,the patient developed progressive pancytopenia. Bone marrow aspirate showed marked hyperplasia of bone marrow cells with 92.5% promyelocyte, consistent with APL. Cytogenetic analysis demonstrated t(15;17)(q22;q21) as the sole abnormality. PML/RARα fusion gene was positive and Kit mutation was negative. After combined treatment with ATRA, arsenic trioxide and idarubicin, patient achieved cytogenetic and molecular remission.

CONCLUSION:

The metachronous coexistence of GIST with APL is uncommon. The potential nonrandom association and causal relationship between these malignancies remained to be investigated. Further studies would be necessary to clarify the relationship between imatinib and secondary malignancies in GIST patients.

• Authors: Ya-Ping Yu, Ping Song, Jian-Gang Mei, Zhi-Ming An, Xiao-Gang Zhou, Feng Li, Li-Ping Wang, Yu-Mei Tang, Yong-Ping Zhai
• Journal: Zhongguo shi yan xue ye xue za zhi (Zhongguo Shi Yan Xue Ye Xue Za Zhi) Vol. 25 Issue 2 Pg. 358-364 (Apr 2017) ISSN: 1009-2137 [Print] China
• PMID: 28446275 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antineoplastic Agents
• Oncogene Proteins, Fusion
• Tretinoin
• Imatinib Mesylate

Topics

• Antineoplastic Agents (adverse effects, therapeutic use)
• Female
• Gastrointestinal Stromal Tumors (drug therapy)
• Humans
• Imatinib Mesylate (adverse effects, therapeutic use)
• Leukemia, Promyelocytic, Acute (chemically induced)
• Middle Aged
• Neoplasms, Second Primary (chemically induced)
• Oncogene Proteins, Fusion
• Tretinoin