Acute promyelocytic leukaemia with t(15;17) following treatment of Hodgkin's disease - a report of 4 cases

Background: Therapy-related acute myeloid leukemia (t-AML) is a recognized entity complicating successful therapy for Hodgkin's disease (HD) and other neoplasias after many years. This risk appears to be related to cumulative exposure to alkylating agents and procarbazine, while drugs affecting DNA - topoisomerase II, such as epipodophyllo-toxins and anthracyclines, are also associated with t-AML developing after a much shorter latent period.Patients and methods: Of 56 patients with t-AML or myelodysplasia seen in our institutes during the period 1980-1994 we encountered 5 patients with acute promyelocytic leukemia (APL) all of whom had t(15;17). Four of these had been treated for HD with both chemotherapy and radiotherapy, and one with radiotherapy aloneResults: To the best of our knowledge these appear to be the first cases of t-AML in HD with cytogenetically proven t(15; 17). Similarly to other cases of t-APL reported after therapy for neoplasias other than HD, these patients also have a relatively favorable prognosis as seen in de-novo APLConclusions: Although rare, t-APL should be added to the list of late complications of therapy for HD