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360978

No PL in APL: No Perception of Light in Acute Promyelocytic leukemia

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Last updated: 01 Jan 2025

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Abstract

Background: Acute promyelocytic leukemia (APL) is a distinct subtype of acute myeloid leukemia with a favorable prognosis. Hemorrhagic manifestations in APL at presentation are usually due to thrombocytopenia, consumptive coagulopathy, and fibrinolysis. Central nervous system (CNS) hemorrhage carries a risk for CNS relapse and early death in APL patients.
Case Presentation: A 23-year-old male presented with sudden bilateral visual loss and headache. The ocular examination revealed a massive exudative retinal detachment in the right eye and bilateral dense vitreous hemorrhage. APL diagnosis was confirmed through peripheral blood and bone marrow examination, along with cytogenetic and molecular testing.  The patient received 7+3 induction chemotherapy combined with All-trans-retinoic acid. After achieving complete remission, he underwent pars plana vitrectomy and silicone oil injection in the right eye. Intrathecal chemotherapy was considered for CNS prophylaxis after induction. Later, he had a medullary relapse which was managed with salvage therapy and autologous stem cell transplantation.
Conclusion: Although APL has a favorable prognosis, its management can be complicated. It may present with retinal detachment or intraocular hemorrhage. Managing intraocular and intracranial hemorrhage is challenging due to the risks of hemorrhage and coagulopathy. This complexity is further heightened by poor visual prognosis, high risk of CNS infiltration, and potential for medullary relapse.

DOI

10.21608/resoncol.2024.260818.1205

Keywords

Acute promyelocytic leukemia, CNS hemorrhage, retinal detachment, Retinal hemorrhage, Vitreous Hemorrhage

Authors

First Name

Dina

Last Name

Laimon

MiddleName

N.

Affiliation

Mansoura University Ophthalmic Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Email

dinalaimon87@mans.edu.eg

City

Mansoura

Orcid

-

First Name

Mohammed

Last Name

Gad

MiddleName

-

Affiliation

Mansoura University Ophthalmic Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Email

mgad69@hotmail.com

City

Mansoura

Orcid

-

First Name

Basma

Last Name

Atef

MiddleName

-

Affiliation

Clinical Hematology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Email

basma.atef@mans.edu.eg

City

-

Orcid

-

First Name

Doaa

Last Name

Sakr

MiddleName

H.

Affiliation

Medical Oncology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Email

doaahassan@mans.edu.eg

City

mansoura

Orcid

0000-0001-5916-8455

First Name

Noha

Last Name

Badawy

MiddleName

-

Affiliation

Clinical Hematology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Email

nohamohamed1142@gmail.com

City

Mansoura

Orcid

-

First Name

Raghda

Last Name

Ibrahim

MiddleName

-

Affiliation

Clinical Hematology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Email

raghdaibrahim25@yahoo.com

City

Mansoura

Orcid

-

First Name

Noreen

Last Name

Bayomi

MiddleName

M.

Affiliation

Clinical Hematology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Email

nelbayoumi@gmail.com

City

Mansoura

Orcid

-

First Name

Yasmine

Last Name

Shaaban

MiddleName

-

Affiliation

Clinical Hematology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Email

yasmineessam@mans.edu.eg

City

Mansoura

Orcid

0000-0002-0523-7651

Volume

20

Article Issue

1

Related Issue

48686

Issue Date

2024-06-01

Receive Date

2024-01-05

Publish Date

2024-06-01

Page Start

16

Page End

23

Print ISSN

2357-0687

Online ISSN

2357-0695

Article File

RESONCOL_Volume 20_Issue 1_Pages 16-23.pdf

PDF . 326.5kB

Link

https://resoncol.journals.ekb.eg/article_360978.html

Detail API

https://resoncol.journals.ekb.eg/service?article_code=360978

Order

3

Type

Case reports

Type Code

287

Publication Type

Journal

Publication Title

Research in Oncology

Publication Link

https://resoncol.journals.ekb.eg/

MainTitle

No PL in APL: No Perception of Light in Acute Promyelocytic leukemia

Details

Type

Article

Created At

30 Dec 2024