Abstract

CAYADO GUTIERREZ, Niubys et al. Probable chimera M3: M5 in an acute promyelocytic leukemia patient; different clonal response to treatment with transretinoic acid and chemotherapy. Rev Cubana Hematol Inmunol Hemoter [online]. 2004, vol.20, n.2. ISSN 0864-0289.

A case of acute promyelocytic leukemia in which the presence of hybrid PML/RAR a gene and the internal tandem duplication of FLT3 (DIT/FLT3)were demonstrated at the time of diagnosis was reported in this paper. After the induction treatment with transretinoic acid and chemotherapy, the cytomorphological study of the bone marrow revealed some change into acute monocytic leukemia (AML-M5). The molecular study revealed that PML/RARa had disappeared but ITD/FLT3 remained. These results suggest that two independent leukemia clones co-exist, that is, one promyeolytic (M3) with chimeric gene PML/RARa and the other monocytic (M5) with ITD/FLT3). Although the hematological and molecular evolution supports such a suggestion, the presence of ITD/FLT3 in clone M3 can not be ignored because it is not a specific marker for AML-M5

Keywords : promyelocytic acute leukemia; PML/RARa; ITD/FLT; ATRA.