Long-term remission in a case of acute promyelocytic leukemia patient with marked myelofibrosis treated with arsenic trioxide, all-trans retinoic acid and consolidation therapy with daunorubicin plus cytarabine
- 医学院－已发表论文 
Myelofibrosis (MF) is a frequent complication of hematological malignancy. It has been reported that any French-American-British (FAB) subtype of acute myelogenous leukemia (AML) may be complicated by fibrosis, and the severity of fibrosis has been associated with poor prognosis . Acute promyelocytic leukemia (APL), a subtype FAB-M3, has a good prognosis with all-trans retinoic acid (ATRA), and a few cases of severe marrow fibrosis in APL patients have been reported to date and all achieved molecular remission , ,  and . However, as far as we know, its prognostic significance has not yet been established and it is uncertain whether MF can affect the response to arsenic trioxide (ATO) treatment on patients with APL. Bone marrow (BM) fibrosis probably occurs secondary to the activation of normal fibroblasts by cytokines secreted from leukemic cells. For example, the transforming growth factor β (TGF-β), a cytokine correlated with MF, promotes collagen synthesis and fibroblast proliferation in the BM  and . Here, we report a case of an APL patient with severe MF who achieved molecular remission with the ATO treatment. We also made a series of molecular studies to try to clarify the mechanism of MF in APL.