Acute Myeloid Leukemia with t(11;17)(q23;q21)

Case Report

Ann Hematol Oncol. 2015;2(6): 1050.

Acute Myeloid Leukemia with t(11;17)(q23;q21)

Piñán MA*, Balerdi A, Iglesias A, Dueñas M, Olazabal I, Puente M, Amutio E, Del Orbe R, Ancin I and García-Ruiz JC

Department of Haematology, Cruces University Hospital, Vizcaya, Spain

*Corresponding author: Maria Angeles Piñan, Department of Haematology, Cruces University Hospital, Spain

Received: July 14, 2015; Accepted: August 10, 2015; Published: August 12, 2015


Acute promyelocytic leukemia (APL) is characterized by the presence of t(15;17), which generates the PML-RARα transcript and by a good response to treatment with retinoids; However, in some variant types as APL with t(11;17) this benefit is not well established. We present the case of a patient who received chemotherapy associated with acid trans-retinoic (ATRA) who achieved complete molecular response and a long term follow-up survival.

Keywords: APL; PLZF-RARα


Acute myeloid leukemia with t(11;17)(q23;q21) is are variant of APL, with morphologic characteristics that differentiates from the classic form and in which there is little experience of treatment.

Case Presentation

A woman of 49 years old, diagnosed with rheumatoid arthritis in January 2011 and undergone to treatment with corticosteroids, methotrexate and hydroxychloroquine was controlled since March 2012 by leukopenia.

On May 31st of 2012 she consulted for presenting anemia (Hb: 97g/L), leukopenia (1.16 x 109L) and neutropenia (0.2 x 109L), attributed to the treatment with methotrexate, which was suspended and instead, a dose of granulocyte colony stimulating factors (G-CSF) was given to the patient; 24 hours later she developed abdominal pain, nausea, vomits, hematuria and oliguria. Three days later she failed on a relevant renal insufficiency (creatinine: 7.6 mg/dl), deeper anemia and thrombocytopenia. She was treated with hemodialysis, transfusions of red blood cells and platelets and steroids. Nine days later she transferred to our hospital with suspicion Thrombotic Thrmbocitopenic Purpura, so that dialysis and plasma transfusions was rebooted.

Physical examination, abdominal ultrasonography and renal Doppler, showed no abnormalities.

Biochemical profile: Urea: 145 mg/dL (10-50), Creatinine: 4.61 mg/dL (0.1-1.1), LDH: 422 u/L (26-245) and rest of parameters were within normal limits.

Blood test revealed: Hb: 82 g/L, MCV: 94.6 fl, WBC: 7.9 x 109/L (52% of cells in medium size, round nucleus and pseudo-pelger with wide cytoplasm and fine granulation), Platelets: 92 x 109/L (Figure1). Erythrocyte morphology: 2 schistocytes/1000 erythrocytes (Figures 1,2).