Therapy-Related PML-RARα Leukemia: An Emerging Disease. Report of 10 Cases From One Department of Hematology.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1016-1016
Author(s):  
Maida Navarrete ◽  
Teresa Vallespi ◽  
Anny Jaramillo ◽  
Carmen Sánchez-Morata ◽  
Carlos Palacio ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Oral Cancer ◽  
Complete Remission ◽  
De Novo ◽  
Fusion Gene ◽  
Alkylating Agents ◽  
Rare Event ◽  
Prostate Adenocarcinoma ◽  
Promyelocytic Leukaemia ◽  
Solid Organ

Abstract Abstract 1016 Poster Board I-38 Introduction: Therapy-related acute myeloid leukemia (t-AML) following chemotherapy is a distinct diagnostic entity in the WHO classification of hematopoietic malignacies. t-AML with monosomy 5 and 7 (or 5q-/7q-) usually occur late after exposure to alkylating agents, whereas those with balanced translocations, especially involving 11q 23 are associated with exposure to epipodophyllotoxin and shorter latency. The occurrence of acute promyelocytic leukaemia (APL) with PML-RARa rearrangement after treatment of a preceding malignancy is a rare event. APL constitutes 10 % of all AML but only 2.7% are t-APL. Patients, Methods and Results: We reported on a single-center experience about of 10 cases of t-APL; patients were observed between October of 1997 until Abril of 2007. There were 6 males and 4 females. Previous diseases were: 6 solid organ malignancies (3 breast cancer, 1 colon cancer, 1 prostate adenocarcinoma and 1 oral cancer), 3 hematologic malignancies (1 Hodgkin disease, 1 follicular lymphoma and 1 polycytemia vera), and 1 multiple sclerosis. Treatment: all of 6 solid tumors received radiotherapy, besides, 3 breast cancers were treated with topoisomerase II inhibitors and anthracyclines, the prostate adenocarcinoma got hormonal therapy and antimetabolite, two lymphomas and the oral cancer received alkylants agents, polycytemia vera was treated with phosphorus 32 and hydroxiurea, and multiple sclerosis with mitoxantrone. Mean age at diagnosis of first cancer was 52.2 years (range: 19-74) and 59.7 years (range: 34-80) at the second. The mean time between the treatment and diagnosis of t-APL was 69.6 months (range: 12-180) being longer in patients treated with alkylants agents (mean: 84 months). Morphologically, all patients presented with hypergranular or typical promyelocytic leukaemia; moreover, two showed Chèdiak granulation and only in one patient bundles of Auer rods (faggot cells) were not observed. By conventional cytogenetics, 3 out of 10 patients presented with complex karyotype: +4, ider(17)(q10) and del(3)(q23q26),t(9;22) (p24;q12),del(14)(q23q32). In all patients the presence of PML/RARa fusion gene was confirmed by RT-PCR. Patients were treated according to Spanish PHETEMA protocol. Regarding to the prognosis they were classified as: high- risk 2, intermediate-risk: 7 and low-risk: 1 (Sanz et al, Blood 2000; 96:1247). A complete remission (CR) was achieved in 8 patients that received treatment. Two patients died of bleeding at diagnosis. Only one patient had molecular relapse and received arsenic trioxide; currently he is in complete remission. Comments: Therapy-related AML has poor prognosis because of the short duration of response. In contrast, several retrospective studies have described that responses to chemotherapy and prognosis of t-APL is similar to that of de novo APL. Last years, we have observed an increment of t-APL diagnosis, 6 out of 10 of our patients were diagnosed over period of 24 months. Disclosures: Guerra-Moreno: Celgene: Research Funding.

Graft Versus Host Disease after Granulocyte Infusion.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5266-5266
Author(s):  
Cristina Barrenetxea ◽  
Francisco J. Zuazu ◽  
Javier Bueno ◽  
Antonio Julia ◽  
Jose L. Diaz
Keyword(s):  
Complete Remission ◽  
Graft Versus Host Disease ◽  
Hematopoietic Cell Transplantation ◽  
Rare Event ◽  
Skin Lesions ◽  
Solid Organ ◽  
Hematopoietic Stem ◽  
Host Disease ◽  
Graft Versus Host ◽  
New Treatment

Abstract INTRODUCTION Graft versus host disease (GVHD) occurs when immunologycally competent cells are introduced into an immunoincompetent host. GVHD refers to both the immunologic insult and the consequences to the organism. The leading cause of GVHD is hematopoietic cell transplantation (HCT), other causes like solid organ transplants, blood transfusions, and maternal-fetal transfusions also reportedly cause GVHD. CASE We present a 33 years old man, who was diagnosed in October 1997 of acute myeloid leukemia, treated with idarrubicin, etoposid and citarabine (IDICE), with complete remission; after that he received intensification treatment with mitoxanthrone and citarabine, and consolidation with an allogeneic HSCT from a sibling donor. The chimerism was 100% of the donor since first month. There wasn’t any important complications after HSCT; except a GVHD skin, resolved with corticoids. Seven years after HCST, in November 2004, a routine control detected donor’s chimerism 34% with a medullar relapse. Leukemia characteristics were the same than the initials, and a new treatment with IDICE was administrated, showing no response, therefore, a second cycle was administrated. One week after the first treatment fever appeared, which persisted besides large spectre antibiotics, so empiric antifungal treatment was added. Two months after the relapse the patient remained febrile, and skin lesions appeared in head, arms, legs, abdomen and oral mucosa. A biopsy was performed and diagnosed with Fusarium sp. The neutropenia persisted, and the overall status was worsening, so we decided donor granulocyte infusions from two HLA identical sisters; ten days later, neutropenia disappeared, the bone marrow hadn’t blastic cells, and chimerism was 100% donor. A month later, new skin lesions appeared, the biopsy confirmed GVHD and severe liver affectation was also demonstrated by biopsy. It was treated with corticoids and cyclosporine, with rapid resolution. The patient left hospital, and until now chimerism remains 100% donor with complete remission, without treatment for GVHD. CONCLUSION: Graft versus Host disease is usually presented after hematopoietic stem cells infusion but other causes are been reported as lymphocytes infusion, where is not a rare event, and in other cases as granulocytes infusion as in our patient. GVHD after granulocyte infusion is not a common complication even though it has to be taken in mind in patients that show skin or liver affectation after infusion.

scholarly journals Circulating tumor cell heterogeneity in neuroendocrine prostate cancer by single cell copy number analysis

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Vincenza Conteduca ◽  
Sheng-Yu Ku ◽  
Luisa Fernandez ◽  
Angel Dago-Rodriquez ◽  
Jerry Lee ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Single Cell ◽  
De Novo ◽  
Genomic Analysis ◽  
Treatment Resistance ◽  
Circulating Tumor Cell ◽  
Prostate Adenocarcinoma ◽  
Neuroendocrine Prostate Cancer ◽  
Patient Heterogeneity ◽  
Tumor Cell Heterogeneity

AbstractNeuroendocrine prostate cancer is an aggressive variant of prostate cancer that may arise de novo or develop from pre-existing prostate adenocarcinoma as a mechanism of treatment resistance. The combined loss of tumor suppressors RB1, TP53, and PTEN are frequent in NEPC but also present in a subset of prostate adenocarcinomas. Most clinical and preclinical studies support a trans-differentiation process, whereby NEPC arises clonally from a prostate adenocarcinoma precursor during the course of treatment resistance. Here we highlight a case of NEPC with significant intra-patient heterogeneity observed across metastases. We further demonstrate how single-cell genomic analysis of circulating tumor cells combined with a phenotypic evaluation of cellular diversity can be considered as a window into tumor heterogeneity in patients with advanced prostate cancer.

Characteristics and Survival Patterns of Solid Organ Transplant Patients Developing De Novo Colon and Rectal Cancer

2004 ◽  
Vol 47 (11) ◽  
pp. 1898-1903 ◽  
Author(s):  
Harry T. Papaconstantinou ◽  
Bradford Sklow ◽  
Michael J. Hanaway ◽  
Thomas G. Gross ◽  
Thomas M. Beebe ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
De Novo ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Patients ◽  
Colon And Rectal Cancer ◽  
Survival Patterns

De novo convulsive status epilepticus in patients with multiple sclerosis treated with dalfampridine

2018 ◽  
Vol 25 (4) ◽  
pp. 618-621 ◽  
Author(s):  
Emilie Panicucci ◽  
Mikael Cohen ◽  
Veronique Bourg ◽  
Fanny Rocher ◽  
Pierre Thomas ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Status Epilepticus ◽  
De Novo ◽  
Case Reports ◽  
Brain Magnetic Resonance Imaging ◽  
Convulsive Status Epilepticus ◽  
Biological Tests ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
History Of Epilepsy

Background: Dalfampridine extended release (DAL) is a broad-spectrum voltage-gated potassium channel blocker that is indicated in multiple sclerosis to improve the nerve conduction of demyelinated axons. Seizures are a known side effect of DAL, which is contraindicated in patients with a history of epilepsy. Objective: Three cases of multiple sclerosis (MS) with de novo convulsive status epilepticus (CSE) probably related to dalfampridine administration are described. Methods: No patients had a history of seizures or renal impairment. Biological tests were normal. A brain magnetic resonance imaging (MRI) showed diffuse cortical and subcortical atrophy without active inflammatory lesions. Results: All three patients presented with CSE that was attributed to DAL and so was discontinued. Conclusion: These case reports illustrate that, aside from seizures, de novo CSE is a potential complication of MS patients treated with DAL.

scholarly journals Beneficial effects of mycophenolate mofetil on cardiotoxicity induced by tacrolimus in wistar rats

2016 ◽  
Vol 242 (4) ◽  
pp. 448-455 ◽  
Author(s):  
Hanen Ferjani ◽  
Rim Timoumi ◽  
Ines Amara ◽  
Salwa Abid ◽  
Abedellatif Achour ◽  
...  
Keyword(s):  
Dna Damage ◽  
Mycophenolate Mofetil ◽  
Oral Administration ◽  
Protective Effect ◽  
Cardiac Toxicity ◽  
De Novo ◽  
Antioxidant Activities ◽  
Solid Organ Transplantation ◽  
Protein Carbonyl ◽  
Solid Organ

The immunosuppressive drug tacrolimus (TAC) is used clinically to reduce the rejection rate in transplant patients. TAC has contributed to an increased prevalence of cardiovascular disease in patients receiving solid organ transplantation. Mycophenolate mofetil (MMF), a potent inhibitor of de novo purine synthesis, is known to prevent ongoing rejection in combination with TAC. In the present study, we investigated the antioxidant and antigenotoxic effect of MMF on TAC-induced cardiotoxicity in rats. Oral administration of TAC at 2.4, 24, and 60 mg/kg b.w. corresponding, respectively, to 1, 10, and 25% of LD50 for 24 h caused cardiac toxicity in a dose-dependant manner. TAC increased significantly DNA damage level in hearts of treated rats. Furthermore, it increased malondialdehyde (MDA) and protein carbonyl (PC) levels and decreased catalase (CAT) and superoxide dismutase (SOD) activities. The oral administration of MMF at 50 mg/kg b.w. simultaneously with TAC at 60 mg/kg b.w. proved a significant cardiac protection by decreasing DNA damage, MDA, and PC levels, and by increasing the antioxidant activities of CAT and SOD. Thus, our study showed, for the first time, the protective effect of MMF against cardiac toxicity induced by TAC. This protective effect was mediated via an antioxidant process.

Chronic wounds of traumatic origin and oral cancer arising de novo: A potential association?

Oral Oncology ◽  
2022 ◽  
Vol 125 ◽  
pp. 105711
Author(s):  
Gerardo Gilligan ◽  
Eduardo Piemonte ◽  
Jerónimo Lazos ◽  
René Panico
Keyword(s):  
Oral Cancer ◽  
Chronic Wounds ◽  
De Novo ◽  
Potential Association ◽  
Traumatic Origin

The Immunocompromised Surgical Patient and Opportunistic Infections

2017 ◽  
Author(s):  
Kiran Gajurel ◽  
Aruna K Subramanian
Keyword(s):  
De Novo ◽  
Opportunistic Infections ◽  
Organ Transplant ◽  
Surgical Excision ◽  
Suppressive Therapy ◽  
Surgical Patient ◽  
Solid Organ ◽  
Fungal Sinusitis ◽  
Delay In Diagnosis ◽  
Immunosuppressive Medications

Immunosuppressive medications used to prevent allograft rejection render solid-organ transplant recipients vulnerable to various opportunistic infections. These infections include bacteria, viruses, fungi, and parasites and occur either via reactivation of previously acquired latent infection or de novo acquisition from the donor organ itself or the environment after the transplantation. The type and clinical course of the infection depend on various factors, including the transplanted organ, nature of immunosuppressive regimens, timing of infection relative to the organ transplant, and type and duration of prophylaxis. Proper donor and recipient screening for preventable infections and posttransplantation prophylaxis are instrumental in preventing morbid infections. Posttransplantation infections may present with subtle findings and thus may cause a delay in diagnosis and treatment, resulting in a poor outcome. Appropriate pathogen-specific tests should be requested promptly for early diagnosis. Since these infections may have overlapping clinical and radiologic features, tissue biopsy, if feasible, should be done to establish a definitive diagnosis. Surgical excision or débridement should be attempted in patients presenting with abscesses or invasive fungal sinusitis along with antimicrobial therapy. After the completion of treatment, suppressive therapy may be required in certain infections to prevent a relapse as long as the patient remains immunosuppressed. This review contains 3 tables, and 82 references. Key words: allograft, donor, immunocompromised, infection, opportunistic, organ, transplant 

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