지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2011.1
- 수록면
- 9 - 12 (4page)
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초록· 키워드
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Central nervous system (CNS) involvement in acute promyelocytic leukemia (APL) is rare, and the presence of CNS symptoms at the time of diagnosis of APL is even rarer. We report 2 cases of APL presenting with CNS involvement. A 43-yr-old woman presented with easy bruising and stuporous mentality. Her complete blood count (CBC) revealed leukocytosis with increased blasts. Bone marrow (BM) analysis was carried out, and the diagnosis of APL was confirmed. This was done by cytogenetic analysis and demonstration of PML-RARα rearrangement by reverse transcriptase PCR in the BM cells. A lumbar puncture was performed to investigate the cause of her stuporous mentality, and her cerebrospinal fluid (CSF) analysis revealed 97% leukemic promyelocytes. Despite systemic and CNS therapy, she died due to septic shock by infection and rapid disease progression only 3 days after her admission. Another patient, a 3-yr-old girl, presented with easy bruising and epistaxis, and her CBC showed pancytopenia with increased blasts. BM studies confirmed APL. Quantitative PCR for PML-RARα in the BM cells revealed a PML-RARα/ABL ratio of 0.33 and CSF analysis revealed 9.5% leukemic promyelocytes (2 of 21 cells). She received induction chemotherapy and intrathecal therapy and achieved complete remission (CR) in the BM and CNS. She has been maintained in the CR status for the past 31 months. Thus, patients with APL must be evaluated for CNS involvement if any neurological symptoms are present at the time of diagnosis.
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참고문헌 (15)
참고문헌 신청
Bae Sung Hwa / 2004 / Meningeal Relapse in a Patient with Acute Promyelocytic Leukemia: A Case Report and Review of the Literature / Journal of Korean Medical Science 19 (2)
Chow J / 2009 / Isolated central nervous system recurrence of acute promyelocytic leukemia in children / Pediatr Blood Cancer 52 : 11 ~ 13
Classen CF / 2003 / Long-term remission of APL with a second allogeneic BMT after CNS relapse following HLA-identical allogeneic BMT / Bone Marrow Transplant 32 : 843 ~ 846
Collins C / 2010 / Central nervous system involvement at the time of presentation in acute promyelocytic leukemia / Pediatr Blood Cancer 54 : 603 ~ 605
Evans GD / 1999 / Extramedullary disease in acute promyelocytic leukemia / Leuk Lymphoma 33 : 219 ~ 229
Chow J / 2009 / Isolated central nervous system recurrence of acute promyelocytic leukemia in children / Pediatr Blood Cancer 52 : 11 ~ 13
Classen CF / 2003 / Long-term remission of APL with a second allogeneic BMT after CNS relapse following HLA-identical allogeneic BMT / Bone Marrow Transplant 32 : 843 ~ 846
Collins C / 2010 / Central nervous system involvement at the time of presentation in acute promyelocytic leukemia / Pediatr Blood Cancer 54 : 603 ~ 605
Evans GD / 1999 / Extramedullary disease in acute promyelocytic leukemia / Leuk Lymphoma 33 : 219 ~ 229
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