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Clinical and pathologic features of secondary acute promyelocytic leukemia

Amy S Duffield1, Joseph Aoki, Mark Levis

  • 1Department of Pathology, The Johns Hopkins Hospital, Baltimore, MD, USA.

American Journal of Clinical Pathology
|February 17, 2012
PubMed

Insights

Secondary acute promyelocytic leukemia (APL) shares key features with de novo APL, suggesting it is a distinct entity. This finding differentiates APL from other secondary acute myeloid neoplasms with poor prognoses.

Area of Science:

  • Hematology
  • Oncology

Background:

  • Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia (AML) with a generally favorable prognosis.
  • Secondary AMLs, including therapy-related AML and AML with myelodysplasia-related changes, typically have a poor prognosis.

Purpose of the Study:

  • To investigate the clinical and pathological characteristics of secondary APL.
  • To compare secondary APL with de novo APL to determine if they are distinct entities.

Main Methods:

  • Retrospective review of 9 cases of secondary APL with a history of chemotherapy, radiotherapy, immunosuppression, or myelodysplastic syndrome.
  • Comparison of clinical and pathological findings between secondary APL and de novo APL cases.

Main Results:

  • Secondary and de novo APL cases exhibited similar abnormal promyelocyte morphology and immunophenotypic features.
  • Cytogenetic findings, FMS-like tyrosine kinase mutations, and rates of disease recurrence and death were comparable between secondary and de novo APL.

Conclusions:

  • Secondary APL demonstrates similar characteristics to de novo APL.
  • These findings support classifying secondary APL as distinct from other secondary acute myeloid neoplasms.

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