tretinoin and Leukemia--Radiation-Induced

The myelodysplastic syndromes represent a preleukaemic state in which a clonal abnormality of haemopoietic stem cell is characterised by a variety of phenotypic manifestations with varying degrees of ineffective haemopoiesis. This state probably develops as a sequence of events in which the earliest stages may be difficult to detect by conventional pathological techniques. The process is characterised by genetic changes leading to abnormal control of cell proliferation and differentiation. Expansion of an abnormal clone may be related to independence from normal growth factors, insensitivity to normal inhibitory factors, suppression of normal clonal growth, or changes in the immunological or nutritional condition of the host. The haematological picture is of peripheral blood cytopenias: a cellular bone marrow, and functional abnormalities of erythroid, myeloid, and megakaryocytic cells. In most cases marrow cells have an abnormal DNA content, often with disturbances of the cell cycle: an abnormal karyotype is common in premalignant clones. Growth abnormalities of erythroid or granulocyte-macrophage progenitors are common in marrow cultures, and lineage specific surface membrane markers indicate aberrations of differentiation. Progression of the disorder may occur through clonal expansion or through clonal evolution with a greater degree of malignancy. Current attempts to influence abnormal growth and differentiation have had only limited success. Clinical recognition of the syndrome depends on an acute awareness of the signs combined with the identification of clonal and functional abnormalities.

Topics: Anemia, Refractory, with Excess of Blasts; Animals; Antineoplastic Agents; Blood Cell Count; Bone Marrow; Cell Transformation, Neoplastic; Cholecalciferol; Chromosome Aberrations; Chromosome Disorders; Colony-Forming Units Assay; Colony-Stimulating Factors; DNA; Hematopoietic Stem Cells; Humans; Leukemia; Leukemia, Radiation-Induced; Mice; Myelodysplastic Syndromes; Oncogenes; Preleukemia; Rats; Tretinoin

The occurrence of acute promyelocytic leukemia (APL) in HIV-infected patients has been reported in only five cases. Due to a very small number of reported HIV/APL patients who have been treated with different therapies with the variable outcome, the prognosis of APL in the setting of the HIV-infection is unclear. Here, we report a case of an HIV-patient who developed APL and upon treatment entered a complete remission. A 25-years old male patient was diagnosed with HIV-infection in 1996, but remained untreated. In 2004, the patient was diagnosed with primary central nervous system lymphoma. We treated the patient with antiretroviral therapy and whole-brain irradiation, resulting in complete remission of the lymphoma. In 2006, prompted by a sudden neutropenia, we carried out a set of diagnostic procedures, revealing APL. Induction therapy consisted of standard treatment with all-trans-retinoic-acid (ATRA) and idarubicin. Subsequent cytological and molecular ana?lysis of bone marrow demonstrated complete hematological and molecular remission. Due to the poor general condition, consolidation treatment with ATRA was given in March and April 2007. The last follow-up 14 months later, showed sustained molecular APL remission. In conclusion, we demonstrated that a complete molecular APL remission in an HIV-patient was achieved by using reduced-intensity treatment.

Topics: Adult; Anti-Retroviral Agents; Antibiotics, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Antiretroviral Therapy, Highly Active; Bisexuality; Brain; Brain Neoplasms; HIV Infections; Humans; Idarubicin; Leukemia, Promyelocytic, Acute; Leukemia, Radiation-Induced; Lymphoma; Male; Remission Induction; Tretinoin

To analyze patient cases of therapy-related acute promyelocytic leukemia (tAPL), occurring after chemotherapy (CT), radiotherapy (RT) or both for a prior disorder, diagnosed during the last 20 years in three European countries.. The primary disorder and its treatment, interval from primary disorder to tAPL, characteristics of tAPL, and its outcome were analyzed in 106 patients.. Eighty of the 106 cases of tAPL were diagnosed during the last 10 years, indicating an increasing incidence of tAPL. Primary disorders were predominantly breast carcinoma (60 patients), non-Hodgkin's lymphoma (15 patients), and other solid tumors (25 patients). Thirty patients had received CT alone, 27 patients had received RT alone, and 49 patients had received both. CT included at least one alkylating agent in 68 patients and at least one topoisomerase II inhibitor in 61 patients, including anthracyclines (30 patients), mitoxantrone (28 patients), and epipodophyllotoxins (19 patients). Median interval from primary disorder to tAPL diagnosis was 25 months (range, 4 to 276 months). Characteristics of tAPL were generally similar to those of de novo APL. With treatment using anthracycline-cytarabine-based CT or all-trans-retinoic acid combined with CT, actuarial survival was 59% at 8 years.. tAPL is not exceptional, and develops usually less than 3 years after a primary neoplasm (especially breast carcinoma) treated in particular with topoisomerase II-targeted drugs (anthracyclines or mitoxantrone and less often etoposide). Characteristics and outcome of tAPL seem similar to those of de novo APL.

Topics: Adult; Aged; Aged, 80 and over; Antibiotics, Antineoplastic; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Belgium; Breast Neoplasms; Child; DNA Topoisomerases, Type II; Female; France; Humans; Leukemia, Promyelocytic, Acute; Leukemia, Radiation-Induced; Lymphoma; Male; Middle Aged; Retrospective Studies; Spain; Treatment Outcome; Tretinoin

The aim of the study was to analyze the incidence of X-ray induced lymphomas in C57B1/10W mice kept on diet with varying retinoid content. The mice whose diet was supplemented with 13-cis retinoic acid (300 mg per kg of chow) developed less lymphomas than those kept on Vitamin A deficient diet as well as on a standard diet (15 mg per kg of chow). Mice subjected to Vitamin A deficient diet displayed a shortening of the latency period.

Topics: Administration, Oral; Animals; Female; Isotretinoin; Leukemia, Radiation-Induced; Lymphoma; Mice; Mice, Inbred Strains; Thymus Neoplasms; Tretinoin