Extramedullary (EM) involvement occurs infrequently in acute promyelocytic leukemia (APL) and usually involves skin and CNS. We describe seven patients (four observed at a single institution) who relapsed in various sites of the auditory apparatus, including the external canal and middle ear (temporal bone). Front-line treatment included ATRA and chemotherapy (six patients) or chemotherapy alone (one patient). Three patients had concomitant hematologic relapse, two had molecular relapse and two were in hematologic and molecular remission when ear localization was documented. Local symptoms that stimulated further diagnostic studies included ear bleeding/discharge in the first patient, but were mild in the others (hypoacusia, five patients; earache, two patients). Ear involvement by leukemia was documented by histological and/or molecular studies after local surgery in five cases, and by CT scan or NMR in the remaining patients. We suggest that the ear might represent a specific sanctuary for disease involvement in APL.

Breccia, M., Petti, M.c., Testi, A.m., Specchia, G., Ferrara, F., Diverio, D., et al. (2002). Ear involvement in acute promyelocytic leukemia at relapse: a disease-associated 'sanctuary'?. LEUKEMIA, 16(6), 1127-30-1130 [10.1038/sj.leu.2402497].

Ear involvement in acute promyelocytic leukemia at relapse: a disease-associated 'sanctuary'?

LO COCO, FRANCESCO
2002-06

Abstract

Extramedullary (EM) involvement occurs infrequently in acute promyelocytic leukemia (APL) and usually involves skin and CNS. We describe seven patients (four observed at a single institution) who relapsed in various sites of the auditory apparatus, including the external canal and middle ear (temporal bone). Front-line treatment included ATRA and chemotherapy (six patients) or chemotherapy alone (one patient). Three patients had concomitant hematologic relapse, two had molecular relapse and two were in hematologic and molecular remission when ear localization was documented. Local symptoms that stimulated further diagnostic studies included ear bleeding/discharge in the first patient, but were mild in the others (hypoacusia, five patients; earache, two patients). Ear involvement by leukemia was documented by histological and/or molecular studies after local surgery in five cases, and by CT scan or NMR in the remaining patients. We suggest that the ear might represent a specific sanctuary for disease involvement in APL.
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/15 - Malattie del Sangue
eng
Adolescent; Adult; Cell Nucleus; Ear; Female; Humans; Leukemia, Promyelocytic, Acute; Male; Middle Aged; Neoplasm Proteins; Oncogene Proteins, Fusion; RNA, Neoplasm; Recurrence; Transcription Factors; Tumor Suppressor Proteins; Leukemic Infiltration; Nuclear Proteins
Breccia, M., Petti, M.c., Testi, A.m., Specchia, G., Ferrara, F., Diverio, D., et al. (2002). Ear involvement in acute promyelocytic leukemia at relapse: a disease-associated 'sanctuary'?. LEUKEMIA, 16(6), 1127-30-1130 [10.1038/sj.leu.2402497].
Breccia, M; Petti, Mc; Testi, Am; Specchia, G; Ferrara, F; Diverio, D; Romano, A; Guerrisi, V; Greco, A; Fiorella, Ml; de Vincentiis, M; Mandelli, F; Lo Coco, F
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2108/161971
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