Late relapse of acute promyelocytic leukemia in a patient with no maintenance therapy

Extremely Late Extramedullary Relapse of Acute Promyelocytic Leukemia, Case Report and Review of the Literature

“…In the literature, late relapses have been well described for 28 (Fig. 3) [12,13] Most cases of late relapsing disease occur within the first 7 years, with the previously longest recorded time to relapse occurring at 155 months. In two cases, the immunophenotypic, cytogenetic, and molecular pattern at relapse were the same as those at diagnosis, which confirmed that the late relapse was indeed a relapse of the original disease, not a new malignancy [14].…”

Genomic analysis of the clonal origin and evolution of acute promyelocytic leukemia in a unique patient with a very late (17 years) relapse

“…and 155 months, respectively, have been reported 128,131,132 . The approach for establishing the diagnosis of relapse in patients with APL relies on the presumption that recurrent disease will be similar to the neoplasm before therapy.…”

Late Relapse of Acute Promyelocytic Leukemia: Literature Review and Results of Seven Years of Clinical and Laboratory Follow-Up of a Korean Patient

“…Coagulation test results included a prothrombin time of 12.4 seconds (reference range, 12.5-14.7), activated partial thromboplastin time of 28 seconds (reference range, 29-43), fibrinogen level of 96 mg/dL (reference range, 200-400), anti-thrombin III level of 0.269 g/L (reference range, 0.19-0.31), and D-dimer level of greater than 20 μg/ mL (reference range < 0.5). The initial complete blood count (CBC) showed a hemoglobin (Hb) level of 8.0 g/dL (reference range, [12][13][14][15][16], platelet count of 26 000/µL (reference range, 150 000-350 000), and white blood cell (WBC) count of 1610/µL (reference range, 4000-10 000), with 32% segmented neutrophils, 58% lymphocytes, 4% monocytes, 1% metamyelocytes, and 5% promyelocytes. Because bone marrow was aspirated via the dry-tap, aspiration slides could not be evaluated.…”

“…8 Most APL relapses occur within 2 years after attaining CR; however, some cases of late relapse (defined as occurring 4 years after attaining CR) have also been reported. [9][10][11][12][13][14][15][16][17][18] Herein, we describe a patient with APL who was given ATRA and induction chemotherapy and who experienced relapse 7 years after CR, which had been continuously monitored by reverse transcription polymerase chain reaction (RT-PCR) for long-term molecular remission. We discuss the clinical course of, and close follow-up data from, this patient and present a brief review of the literature for cases of late-relapsing APL.…”