Acute Myelogenous Leukemia with a t(2;17;4)(p13;q21;p16) Aberration: Effective Treatment with All-Trans Retinoic Acid and Granulocyte Colony-Stimulating Factor.

Abstract

The efficacy of all-trans retinoic acid (ATRA)in patients with acute promyelocytic leukemia (APL) has been well documented. However, ATRA is not as effective against other types of acute myelogenous leukemia (AML)or myelodysplastic syndromes. Wepresent a patient with AML (FAB: M2) associated with a t(2;17;4)(pl3;q21;pl6) chromosomal defect in which the 17q21 breakpoint was not within the retinoic acid receptor a locus which is typically rearranged in APL. This patient was successfully treated with ATRAand granulocyte colony-stimulating factor and improvement ofhematological parameters lasted for 19 months without the use ofcytotoxic agents. (Internal Medicine 38: 150-154, 1999)

Retinoids as Differentiating Agents in Oncology: A Network of Interactions with Intracellular Pathways as the Basis for Rational Therapeutic Combinations

“…1). It is interesting to notice that treatment of a single relapsed APL patient with ATRA and G-CSF resulted in complete clinical remission [148].…”

Signaling revisited in acute promyelocytic leukemia

“…97 Retinoic acid and G-CSF co-operate to induce neutrophilic maturation in the t(15;17)-harboring HT93 cells 100 as well as in acute myelogenous leukemia with a t(2;17;4) aberration. 101 Furthermore, G-CSF renders PLZF-RAR␣-positive APL cells sensitive to RA and is clearly beneficial when associated with RA in patients expressing this fusion protein. 102 This synergism between RA and G-CSF, together with the fact that RA induces G-CSF receptor transcripts strongly suggests a cross-talk between the RA and G-CSF signaling pathways.…”