[All-trans retinoic acid/arsenic trioxide combination therapy for a patient with acute promyelocytic leukemia on dialysis]

Rinsho Ketsueki. 2019;60(10):1431-1435. doi: 10.11406/rinketsu.60.1431.
[Article in Japanese]

Abstract

We report a 55-year-old man who began undergoing hemodialysis for polycystic kidney disease 17 years ago. Because pancytopenia and susceptibility to infection were identified, a bone marrow biopsy was performed, resulting in a diagnosis of acute promyelocytic leukemia (APL). All-trans retinoic acid (ATRA) treatment was initiated, but promyelocytic leukemia/retinoic acid receptor alpha gene fusion without remission was identified by fluorescence in situ hybridization. We administered ATRA/arsenic trioxide (ATO) combination therapy for therapy-resistant APL and confirmed molecular genetic remission. The ATRA/ATO combination therapy was continued, obtaining complete remission 2 years after commencement of treatment. Cystic infections continued during ATRA/ATO combination therapy, similar to infections before APL morbidity, and there were no adverse events leading to treatment discontinuation. ATRA/ATO combination therapy is considered a safe and effective treatment for therapy-resistant APL patients on hemodialysis.

Keywords: Acute promyelocytic leukemia; All-trans retinoic acid; Arsenic trioxide; Dialysis.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols
  • Arsenic Trioxide / therapeutic use*
  • Humans
  • In Situ Hybridization, Fluorescence
  • Leukemia, Promyelocytic, Acute / drug therapy*
  • Male
  • Middle Aged
  • Polycystic Kidney Diseases
  • Remission Induction
  • Renal Dialysis
  • Treatment Outcome
  • Tretinoin / therapeutic use*

Substances

  • Tretinoin
  • Arsenic Trioxide