Hypoplastic acute promyelocytic leukemia with continuous hypocellular bone marrow after remission

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  • NAKAMURA Toshiki
    Department of Hematology, National Hospital Organization Nagasaki Medical Center
  • MAKIYAMA Junya
    Department of Hematology, National Hospital Organization Nagasaki Medical Center Clinical Research Center, National Hospital Organization Nagasaki Medical Center
  • MATSUURA Ayumi
    Department of Clinical Laboratory, National Hospital Organization Nagasaki Medical Center
  • KUROHAMA Hirokazu
    Department of Pathology, National Hospital Organization Nagasaki Medical Center
  • KITANOSONO Hideaki
    Department of Hematology, National Hospital Organization Nagasaki Medical Center
  • ITO Masahiro
    Department of Pathology, National Hospital Organization Nagasaki Medical Center
  • YOSHIDA Shinichiro
    Department of Hematology, National Hospital Organization Nagasaki Medical Center
  • MIYAZAKI Yasushi
    Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University

Bibliographic Information

Other Title
  • 寛解後も低形成骨髄が遷延した低形成性急性前骨髄球性白血病
  • 症例報告 寛解後も低形成骨髄が遷延した低形成性急性前骨髄球性白血病
  • ショウレイ ホウコク カンカイゴ モ テイケイセイ コツズイ ガ センエン シタ テイケイセイ セイキュウセイ ゼン コツズイキュウセイ ハッケツビョウ

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Description

<p>An 87-year old female presented with unsteady gait and occasional subcutaneous hematomas. Blood examination findings revealed pancytopenia and mild coagulopathy. Both the histopathological evaluation of bone marrow smears and bone marrow biopsy revealed a hypocellular bone marrow. However, APL cells were observed and PML-RARA fusion gene was detected. On the basis of these findings, the patient was diagnosed with hypoplastic acute promyelocytic leukemia. She received ATRA treatment and achieved complete remission (CR) 29 days from the commencement of therapy. After the first CR, she received two courses of ATO as a consolidation therapy. Following the latter treatments, she maintained CR, but a hypoplastic bone marrow was still observed. Hypoplastic AML is defined as AML with a low bone marrow cellularity. It is clinically important to distinguish it from aplastic anemia and hypoplastic MDS. It has been suggested that both cytogenetic and morphological diagnosis are imperative to the differential diagnosis of hypocellular bone marrow.</p>

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 59 (4), 414-419, 2018

    The Japanese Society of Hematology

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