Muhammad Nadeem, Sana Mehmood, Nayab Khan, Faisal Mehmood.
Acute Promyelocytic Leukemia with Early CNS Relapse.
J Rawal Med Coll Jan ;18(2):308-9.

Acute promyelocytic leukemia (APL) is a distinct subtype of acute myeloid leukemia (AML) characterized by reciprocal translocation between long arms of chromosome 15 and 17 t(15;17) and presentation with severe coagulopathy which may lead to early death. APL accounts for 10-15% cases of AML. The introduction of all-trans retinoic acid (ATRA) has revolutionized the treatment of APL by almost doubling the cure rate.1 Central nervous system (CNS) involvement can occur at the time of relapse. The incidence of CNS relapse in APL ranges from 0.6- 2% and is seen most commonly in patients presenting with total leucocyte count (TLC) count greater than 10x109/L i.e high risk patients. The 5 year cumulative incidence of CNS relapse in these high risk patients is 5.5% and median time to relapse is 16 months.2 The present case is of young man who while receiving maintenance therapy developed CNS relapse followed closely by molecular relapse.

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