PMID- 29465554
OWN - NLM
STAT- MEDLINE
DCOM- 20180302
LR  - 20220419
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 8
DP  - 2018 Feb
TI  - Case report: Purulent transformation of granulocytic sarcoma: An unusual pattern 
      of differentiation in acute promyelocytic leukemia.
PG  - e9657
LID - 10.1097/MD.0000000000009657 [doi]
LID - e9657
AB  - RATIONALE: Acute promyelocytic leukemia (APL) is a curable subtype of acute 
      myeloid leukemia. APL is currently treated with combination of all-trans retinoic 
      acid (ATRA) and arsenic trioxide (ATO) resulting in the induction of apoptosis 
      and differentiation of the leukemic cells. Differentiation syndrome (so-called 
      ATRA syndrome) is the main life-threatening complication of induction therapy 
      with these differentiating agents. PATIENT CONCERNS: Herein, we report the case 
      of a 49-year-old woman diagnosed with APL with, concomitantly, a bulky cutaneous 
      lesion of 10 cm diameter with a red-to-purple background and a necrotic center, 
      localized on her abdomen. DIAGNOSES: After 10 days of treatment, the cutaneous 
      lesion became purulent. Fluorescence in situ hybridization (FISH) analysis 
      performed on this pus confirmed the presence of malignant features in the 
      involved granulocytes proving their origin from the differentiation of leukemic 
      APL cells, as all the analyzed nuclei showed 2 promyelocytic leukemia 
      (PML)-retinoic acid receptor-a (RARA) fusions signals. INTERVENTION: The 
      association by ATRA and ATO was continued. OUTCOME: Eventually, the evolution was 
      favorable with healing in three weeks. LESSONS: This case report therefore 
      highlights the differentiation phenomenon of promyelocytic blasts within 
      promyelocytic sarcoma with the ATRA-ATO combination and the efficacy of this drug 
      association in resolving both the malignant sarcoma and a secondary local 
      infection.
FAU - Collinge, Elodie
AU  - Collinge E
AD  - Department of Hematology, CHU UCL Namur, Belgium Department of Hematology 
      Laboratory of Hematology Anatomopathology Department of Dermatology, Hospices 
      Civils de Lyon, Centre Hospitalier Lyon Sud LBMC, ENS, CNRS UMR5239, Faculte de 
      Medecine Lyon Sud, Pierre-Benite, France.
FAU - Tigaud, Isabelle
AU  - Tigaud I
FAU - Balme, Brigitte
AU  - Balme B
FAU - Gerland, Luc-Marie
AU  - Gerland LM
FAU - Sujobert, Pierre
AU  - Sujobert P
FAU - Carlioz, Violette
AU  - Carlioz V
FAU - Salles, Gilles
AU  - Salles G
FAU - Thomas, Xavier
AU  - Thomas X
FAU - Paubelle, Etienne
AU  - Paubelle E
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Arsenicals)
RN  - 0 (Oxides)
RN  - 5688UTC01R (Tretinoin)
RN  - S7V92P67HO (Arsenic Trioxide)
SB  - IM
MH  - Abdomen/pathology
MH  - Antineoplastic Combined Chemotherapy Protocols/administration & dosage/*adverse 
      effects
MH  - Arsenic Trioxide
MH  - Arsenicals/administration & dosage/*adverse effects
MH  - Cell Differentiation/drug effects
MH  - Female
MH  - Humans
MH  - Induction Chemotherapy/adverse effects
MH  - Leukemia, Promyelocytic, Acute/*drug therapy
MH  - Middle Aged
MH  - Oxides/administration & dosage/*adverse effects
MH  - Sarcoma, Myeloid/chemically induced/*drug therapy/pathology
MH  - Suppuration/chemically induced
MH  - Tretinoin/administration & dosage/*adverse effects
PMC - PMC5841987
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2018/02/22 06:00
MHDA- 2018/03/03 06:00
PMCR- 2018/02/23
CRDT- 2018/02/22 06:00
PHST- 2018/02/22 06:00 [entrez]
PHST- 2018/02/22 06:00 [pubmed]
PHST- 2018/03/03 06:00 [medline]
PHST- 2018/02/23 00:00 [pmc-release]
AID - 00005792-201802230-00019 [pii]
AID - MD-D-17-06943 [pii]
AID - 10.1097/MD.0000000000009657 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Feb;97(8):e9657. doi: 10.1097/MD.0000000000009657.