Central Nervous System Recurrence in a Patient Treated for Acute Promyelocytic Leukemia, Resulting in Sideroblastic Anemia: A Case Report

Division

East Florida

Hospital

Westside Regional Medical Center

Document Type

Review Article

Publication Date

2-25-2022

Keywords

Acute promyelocytic leukemia, Central nervous system relapse, Sideroblastic anemia, All-transretinoic acid, Myelodysplasia, Case report

Disciplines

Hemic and Lymphatic Diseases | Internal Medicine | Nervous System Diseases

Abstract

BACKGROUND

Previous cases that have been stated in this article have displayed that around 1% to 7% of patients that have been treated with chemotherapy for acute promyelocytic leukemia developed myelodysplastic syndrome or acute myeloid leukemia. One can see that’s why this case presentation of a 60-year-old man that had a good response to acute promyelocytic leukemia treatment, that later presented with a central nervous system recurrence of acute promyelocytic leukemia and acquired sideroblastic anemia (a form of myelodysplasia) from treatment is a unique case report.

CASE SUMMARY The presence of central nervous system relapse in acute promyelocytic leukemia patients is very unlikely compared to recurring mainly in the bone marrow. It is also uncommon to be diagnosed with sideroblastic anemia (form of myelodysplastic syndrome) as a result from treatment for acute promyelocytic leukemia. This case report highlights the detection, treatment/maintenance with idarubicin, all-trans-retinoic-acid, arsenic trioxide, methotrexate, 6-mercaptopurine, and ommaya reservoir intrathecal methotrexate administration in a patient that had central nervous system relapse of acute promyelocytic leukemia and acquired sideroblastic anemia. CONCLUSION In essence, first time relapse concerning the central nervous system in treated acute promyelocytic leukemia patients who had a good response to therapy is very uncommon. The acquirement of a myelodysplastic syndrome such as ringed sideroblastic anemia is also rare regarding this patient population. Although such cases are infrequent, this case report represents a unique insight of the detection, treatment, and maintenance of a 60-year-old man diagnosed with acute promyelocytic leukemia, resulting in the acquirement of sideroblastic anemia and central nervous system relapse.

Publisher or Conference

World Journal of Hematology

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