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• W2365459081 abstract "Objective To investigate the diagnosis and treatment of de novo acute promyelocytic leukemia ( APL) after liver transplantation. Methods One case developed APL among patients who were regularly followed up after liver transplantation in the Third Affiliated Hospital of Sun Yat-sen University from October 2003 to December 2012. Clinical data of the patient,including clinical manifestations,diagnosis, treatment and prognosis,were retrospectively analyzed. A scientific literature search was undertaken in thedomestic and foreign medical databases,like Pubmed and Wanfang Medical Database. Clinical characteristics of patients with leukemia especially APL patients after liver transplantation were analyzed,such as age,gender, primary disease,the immunosuppression regimen,the postoperative elapsed time,the types of leukemia,the types of chromosome mutations,treatment,prognosis and the cause of death. Results At 52 months after liver transplantation,the patient was found a reduction in the number of peripheral white blood cells in the follow-up clinic,without any sign,symptom,infection or bleeding tendency. After the failure of treatment of recombinant human granulocyte colony-stimulating factor,the diagnosis of acute myeloid leukemia ( AML) type M3 ( APL) was confirmed by bone marrow biopsy. After combined treatment of vitamin A acid and compound realgar natural indigo tablet ( main chemical component was arsenic disulfide ) , the patient achieved complete remission. There were 34 reported cases of leukemia after liver transplantation in the literature including this case. Among them,there were 22 cases of AML including 18 adults and 4 children. The median of postoperative elapsed time was 26 months ( range from 38 d to 8 years) . The most common AML subtype was APL ( 8 /18,44% ) and all accompanied with abnormal karyotype t ( 15; 17) . Therapeutic regimen consisted of vitamin A acid,arsenic trioxide and chemotherapy drugs like daunorubicin or cytarabine. The overall mortality of AML patients was 59% ( 13 /22) and the main causes of death included disseminated intravascular coagulation ( DIC) ,infection,liver failure and heart failure. The deaths included 2 cases ( 2 /8) of APL and 11 cases ( 79% ,11 /14) of the other types of AML,where significant difference was observed ( P 0. 05) . Six APL patients achieved complete remission and the other two died of DIC and sepsis respectively. Conclusions The general prognosis of de novo AML after liver transplantation is not good but the prognosis of APL patients is better than that of the other types of AML. Early diagnosis and timely treatment is the key to improve the prognosis of APL after liver transplantation." @default.
• W2365459081 created "2016-06-24" @default.
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• W2365459081 date "2013-01-01" @default.
• W2365459081 modified "2023-09-25" @default.
• W2365459081 title "Diagnosis and treatment of de novo acute promyelocytic leukemia after liver transplantation" @default.
• W2365459081 hasPublicationYear "2013" @default.
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