UTSUGISAWA Taiju    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Associate Professor
Article types	Original article
Language	English
Peer review	Peer reviewed
Title	Clonal evolution of blasts in an elderly patient with CD56(+) relapsed acute promyelocytic leukemia.
Journal	Formal name：American journal of hematology Abbreviation：Am J Hematol ISSN code：03618609/03618609
Domestic / Foregin	Foregin
Volume, Issue, Page	69(1),pp.59-63
Author and coauthor	Itoh Shigeki, Sugawara Takeshi, Enomoto Sanae, Ono Yoko, Numaoka Hideharu, Utsugisawa Taiju, Murai Kazunori, Ishida Yoji, Kuriya Shin-ichiro
Publication date	2002/01
Summary	We describe an elderly patient with acute promyelocytic leukemia (APL), whose leukemic cells expressed CD56 antigen at relapse but not at diagnosis. Chromosome analysis revealed that blasts with t(8;15;17)(q24.1;q22;q11.2) increased from 4 of 20 cells (20%) at first relapse to 10 of 14 cells (71.4%) at second relapse. In addition, the positivity for CD56 expression on blasts judged by flow cytometric analysis using CD45 blast gating was also increased from 14.2% at first relapse to 75% at second relapse. Although conventional chemotherapy was performed for the initial disease and the first relapse, relapse developed again. Therefore, three courses of intensive postremission chemotherapy including concurrent administration of recombinant human granulocyte colony-stimulating factor (rhG-CSF) with cytarabine were performed after achievement of complete remission (CR) by the treatment with all-trans-retinoic acid (ATRA). Although PML-RARalpha mRNA was not detectable by reverse transcription polymerase chain reaction (RT-PCR), a third relapse occurred. This case demonstrated clonal evolution from a CD56(-) to a CD56(+) blast population and provided further support for the suggestion that CD56 expression might be an unfavorable prognostic factor in t(15;17) APL.
DOI	10.1002/ajh.10005
PMID	11835333