All-<i>trans</i> retinoic acid/arsenic trioxide combination therapy for a patient with acute promyelocytic leukemia on dialysis

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  • NAGAO Riku
    Department of Hematology, Kawaguchi Municipal Medical Center Department of Oncology and Hematology, Jikei University School of Medicine
  • HOSOBA Rika
    Department of Oncology and Hematology, Jikei University School of Medicine
  • YAHAGI Yuichi
    Department of Hematology, Kawaguchi Municipal Medical Center
  • GUNJI Tadahiro
    Department of Oncology and Hematology, Jikei University School of Medicine
  • URYU Hideki
    Department of Oncology and Hematology, Jikei University School of Medicine
  • HATTORI Daiki
    Department of Oncology and Hematology, Jikei University School of Medicine
  • MOMOKI Mamiko
    Department of Hematology, Kawaguchi Municipal Medical Center Department of Oncology and Hematology, Jikei University School of Medicine
  • YAMAZAKI Hiroyuki
    Department of Hematology, Kawaguchi Municipal Medical Center

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Other Title
  • All-<i>trans</i> retinoic acid/arsenic trioxide併用療法が有効であった透析患者に合併した急性前骨髄球性白血病
  • 症例報告 第9回日本血液学会関東甲信越地方会 奨励賞 All-trans retinoic acid/arsenic trioxide併用療法が有効であった透析患者に合併した急性前骨髄球性白血病
  • ショウレイ ホウコク ダイ9カイ ニホン ケツエキ ガッカイ カントウ コウシンエツチホウカイ ショウレイショウ All-trans retinoic acid/arsenic trioxide ヘイヨウ リョウホウ ガ ユウコウ デ アッタ トウセキ カンジャ ニ ガッペイ シタ 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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Abstract

<p>We report a 55-year-old man who began undergoing hemodialysis for polycystic kidney disease 17 years ago. Because pancytopenia and susceptibility to infection were identified, a bone marrow biopsy was performed, resulting in a diagnosis of acute promyelocytic leukemia (APL). All-trans retinoic acid (ATRA) treatment was initiated, but promyelocytic leukemia/retinoic acid receptor alpha gene fusion without remission was identified by fluorescence in situ hybridization. We administered ATRA/arsenic trioxide (ATO) combination therapy for therapy-resistant APL and confirmed molecular genetic remission. The ATRA/ATO combination therapy was continued, obtaining complete remission 2 years after commencement of treatment. Cystic infections continued during ATRA/ATO combination therapy, similar to infections before APL morbidity, and there were no adverse events leading to treatment discontinuation. ATRA/ATO combination therapy is considered a safe and effective treatment for therapy-resistant APL patients on hemodialysis.</p>

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 60 (10), 1431-1435, 2019

    The Japanese Society of Hematology

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