잠시만 기다려 주세요. 로딩중입니다.

Acute Promyelocytic Leukemia After Radium-223 Exposure for Prostate Cancer in a Chemotherapy-Naive Patient

Nuclear Medicine and Molecular Imaging 2020년 54권 5호 p.256 ~ 260
Perrone Salvatore, La Barbera Elettra Ortu, Ottone Tiziana, Capriata Marcello, Passucci Mauro, Filippi Luca, Bagni Oreste, Voso Maria Teresa, Cimino Giuseppe,
소속 상세정보
 ( Perrone Salvatore ) - Via A. Canova S. M. Goretti Hospital
 ( La Barbera Elettra Ortu ) - Via A. Canova S. M. Goretti Hospital
 ( Ottone Tiziana ) - University of Rome Tor Vergata Department of Biomedicine and Prevention
 ( Capriata Marcello ) - Sapienza University Department of Medical Oncology, Medical and Surgical Sciences and Biotechnology
 ( Passucci Mauro ) - Sapienza University Department of Medical Oncology, Medical and Surgical Sciences and Biotechnology
 ( Filippi Luca ) - Santa Maria Goretti Hospital Department of Nuclear Medicine
 ( Bagni Oreste ) - Santa Maria Goretti Hospital Department of Nuclear Medicine
 ( Voso Maria Teresa ) - University of Rome Tor Vergata Department of Biomedicine and Prevention
 ( Cimino Giuseppe ) - Via A. Canova S. M. Goretti Hospital

Abstract


223Ra-dichloride is a bone-seeking targeted alpha (α)-emitting approved for bone metastases in prostate cancer. Here, we report a case of therapy-related acute promyelocytic leukemia (t-APL) following administration of 223Ra, showing some evidence of a causative relationship. A patient with metastatic prostate cancer received therapy with 223Ra, with 6 injections of the radiopharmaceutical at a standard dose of 55 kBq/kg at 4-week intervals for a cumulative administered activity of 26.3 MBq. PET/CT with 18F-methylcholine repeated 1 month after the conclusion of 223Ra was negative. After 8 months, he developed pancytopenia and we made a diagnosis of therapy-related acute promyelocytic leukemia (t-APL). We then studied the genomic locations of the breakpoints in the PML and RARA genes, which were at nucleotide positions 1708-09 of PML intron 3, respectively, outside the previously reported Topo II-associated hotspot region. t-APL was cured with all-trans-retinoic acid (ATRA) and arsenic trioxide. The type of PML/RARA rearrangement we identified, in absence of other myelotoxic treatments, is suggestive of a possible direct causal relationship with exposure to 223Ra and warrants further investigations.

키워드

Acute promyelocytic leukemia; Prostate cancer. radium-223; Therapy-related acute myeloid leukemia

원문 및 링크아웃 정보

등재저널 정보