Abstract

  We describe a case of progressive multifocal leukoencephalopathy (PML) in a patient on maintenance chemotherapy for high-risk acute promyelocytic leukemia (APL). The highlight of this scenario is the clinical improvement of the PML after the cessation of maintenance chemotherapy. We demonstrate that profound immunosuppression can occur during maintenance chemotherapy for APL. The role of post-consolidation maintenance chemotherapy in APL is controversial and previous studies demonstrated an improved disease-free survival with observation versus maintenance chemotherapy for APL. A phase 3 study by Lo Coco., et al. (2013) concluded that ATRA plus ATO with no maintenance chemotherapy was not inferior to standard chemotherapy. This case emphasizes that maintenance chemotherapy is associated with infectious risks the role for maintenance chemotherapy in APL should be re-evaluated.

Keywords: PML Progressive Multifocal Leukoencephalopathy; JC Virus; Leukemia; ATRA; Maintenance Chemotherapy; ATO (Arsenic Trioxide); Immunosuppression; Myoclonus

References

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Citation

Citation: Catherine Maurice., et al. "Maintenance Chemotherapy in Acute Promyelocytic Leukemia: The Thin Line Between Survival and Immunosuppression".Acta Scientific Cancer Biology 4.2 (2020): 51-53.

Copyright

Copyright: © 2020 Catherine Maurice., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.