Thinking in Diagnosis and Treatment of Acute Promyelocytic Leukemia with Philadelphia Chromosome Positivity
LAN Hai-feng
YANG Wen-zhong
JIANG Hong
JIA Xin-yan
GAO Yong
Abstract：Objective To explore the clinical features, diagnosis and treatment of acute promyelocytic leukemia ( APL) with philadelphia chromosome ( Ph) positivity in order to avoid misdiagnosis and mistreatment. Methods Clinical data of a patient with Ph-positive acute promyelocytic leukemia manifesting as acute myelomonocytic leukemia was retrospec-tively analyzed, and related literature was reviewed. Results The patient was admitted for fever over three weeks. Primary diagnosis was acute myelomonocytic leukemia after examinations of morphologic, immunophenotypic and histochemistry. But the standard IDA regimen was ineffective, which used idarubicin and cytarabine. APL with positive Ph was confirmed by cyto-genetics and morphologic studies. Complete remission was obtained after treatment with all-trans-retinoic acid ( ATRA) and arsenic trioxide ( ATO) . There was no evidence of recurrence for 8 months after 4 cycles of consolidation therapy. PML-RARA fusion gene was changed to be negative, but BCR-ABL fusion gene was still positive. Conclusion Cytogenetic examination for suspected acute leukemia patients is necessary to reduce misdiagnosis and improve the therapeutic effect.
Keywords：LeukemiapromyelocyticacutepositivePhiladelphia chromosomeDiagnostic errorsmyelomonocytic
Publication Date：2014-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 1-4 )