Evidence map›Paper›PMID 28830803›Full record

ArticleHematology/oncology and stem cell therapy2019

Acute promyelocytic leukemia in a patient with chronic lymphocytic leukemia-A case report.

Prajwal Boddu, Ellen Schlette, Beenu Thakral, Guillin Tang, Naveen Pemmaraju, Tapan Kadia, Alessandra Ferrajoli, Farhad Ravandi, William Wierda, Nitin Jain

Open access · diamondAbstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Hematology/oncology and stem cell therapy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 44% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Prajwal BodduDepartment of Leukemia, MD Anderson Cancer Center, The University of Texas, Houston, TX, USA.
Ellen SchletteDepartment of Hematopathology, MD Anderson Cancer Center, The University of Texas, Houston, TX, USA.
Beenu ThakralDepartment of Hematopathology, MD Anderson Cancer Center, The University of Texas, Houston, TX, USA.
Guillin TangDepartment of Hematopathology, MD Anderson Cancer Center, The University of Texas, Houston, TX, USA.
Naveen PemmarajuDepartment of Leukemia, MD Anderson Cancer Center, The University of Texas, Houston, TX, USA.
Tapan KadiaDepartment of Leukemia, MD Anderson Cancer Center, The University of Texas, Houston, TX, USA.
Alessandra FerrajoliDepartment of Leukemia, MD Anderson Cancer Center, The University of Texas, Houston, TX, USA.
Farhad RavandiDepartment of Leukemia, MD Anderson Cancer Center, The University of Texas, Houston, TX, USA.
William WierdaDepartment of Leukemia, MD Anderson Cancer Center, The University of Texas, Houston, TX, USA.
Nitin JainDepartment of Leukemia, MD Anderson Cancer Center, The University of Texas, Houston, TX, USA. Electronic address: njain@mdanderson.org.
The University of Texas MD Anderson Cancer Center · US

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Fabien Delerue · 1985 to 2026
$290.8M
TOLERANCE INDUCTION BY MEGADOSE STEM CELL TRANSPLANTS IN CML--GVHD AND GVLP01CA049639 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI SHPALL, ELIZABETH J · 1990 to 2014
$41.8M
NCI NIH HHS P01 CA049639NCI NIH HHS P30 CA016672
6 · The paper itself

Abstract

Chronic lymphocytic leukemia (CLL) is known to be associated rarely with myeloid malignancies such as acute myelogenous leukemia. In this article, we report an extremely rare occurrence of acute promyelocytic leukemia in a patient with CLL. A 71-year-old man first presented to our clinic with a diagnosis of CLL and worsening motor neuropathy symptoms. It was suspected that his CLL might be contributing to the neuropathy as a paraneoplastic syndrome, and he was treated with rituximab monotherapy in weekly doses for the 1st month and monthly treatments thereafter. By the end of his sixth monthly course of rituximab, the patient noted significant improvement in neuropathy symptoms but reported experiencing a new-onset worsening fatigue. He had new-onset cytopenias (white blood cells 1.6k/µL, hemoglobin 11.7g/dL, and platelet count 77k/µL). A bone marrow examination was performed; it showed a high percentage of progranulocytes (21%), which stained positive for myeloperoxidase (MPO) and demonstrated a fine granular pattern on the promyelocytic leukemia (PML) oncogenic domain immunofluorescence test. The diagnosis of acute promyelocytic leukemia was confirmed by fluorescence in situ hybridization, which showed a PML/RARα rearrangement in 46% of interphases. Flow cytometry was consistent with immunophenotype of acute promyelocytic leukemia and minimal residual CLL (0.07%). The patient was started promptly on all-trans-retinoic acid and arsenic trioxide induction regimen. Molecular remission was achieved after the first consolidation cycle. The patient is currently past his fourth consolidation cycle of all-trans-retinoic acid/arsenic trioxide and continues to be in complete remission. Our case illustrates that it is important for the physicians to be aware of coexistent hematologic and solid tumor malignancies in CLL, and maintain a low threshold for diagnostic testing based on grounds of low clinical suspicion.

Indexed as

AgedAntineoplastic AgentsArsenic TrioxideHumansLeukemia, Lymphocytic, Chronic, B-CellLeukemia, Promyelocytic, AcuteMaleRituximabTretinoinAntineoplastic AgentsArsenic TrioxideRituximabTretinoinAcute myeloid leukemiaAcute promyelocytic leukemiaChronic lymphocytic leukemiaRituximab

Identifiers

PMID28830803
PMCPMC11575698
OpenAlexW2747891832

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.