Acute promyelocytic leukemia other imaging studies: Difference between revisions
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{{Acute promyelocytic leukemia}} | {{Acute promyelocytic leukemia}} | ||
{{CMG}} {{ | {{CMG}}; {{AE}} {{shyam}}, {{S.G.}}; {{GRR}} {{Nat}} | ||
==Overview== | ==Overview== | ||
| Line 9: | Line 9: | ||
==Acute promyelocytic leukemia other imaging findings== | ==Acute promyelocytic leukemia other imaging findings== | ||
*'''Echocardiogram''': | *'''Echocardiogram''': | ||
**An [[echocardiogram]] is an essential | **An [[echocardiogram]] is an essential imaging modality in patients with acute promyelocytic leukemia receiving [[anthracycline]] [[chemotherapy]].<ref name="pmid22917553">{{cite journal| author=Neilan TG, Coelho-Filho OR, Pena-Herrera D, Shah RV, Jerosch-Herold M, Francis SA et al.| title=Left ventricular mass in patients with a cardiomyopathy after treatment with anthracyclines. | journal=Am J Cardiol | year= 2012 | volume= 110 | issue= 11 | pages= 1679-86 | pmid=22917553 | doi=10.1016/j.amjcard.2012.07.040 | pmc=3496816 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22917553 }} </ref> | ||
** | **Patients who will be receiving anthracycline-based therapy require a baseline echocardiogram to assess the [[ejection fraction]] prior to therapy.<ref name="pmid28185035">{{cite journal |vauthors=McGowan JV, Chung R, Maulik A, Piotrowska I, Walker JM, Yellon DM |title=Anthracycline Chemotherapy and Cardiotoxicity |journal=Cardiovasc Drugs Ther |volume=31 |issue=1 |pages=63–75 |date=February 2017 |pmid=28185035 |pmc=5346598 |doi=10.1007/s10557-016-6711-0 |url=}}</ref> | ||
**[[Anthracycline|Anthracyclines]] are known to cause | **[[Anthracycline|Anthracyclines]] are known to cause cardiac toxicity (specifically [[cardiomyopathy]] with cumulative anthracycline doses above 500mg/m2).<ref name="pmid18203425">{{cite journal |vauthors=Rahman AM, Yusuf SW, Ewer MS |title=Anthracycline-induced cardiotoxicity and the cardiac-sparing effect of liposomal formulation |journal=Int J Nanomedicine |volume=2 |issue=4 |pages=567–83 |date=2007 |pmid=18203425 |pmc=2676818 |doi= |url=}}</ref> | ||
*'''Chest X-ray''': Chest radiography is useful in the assessment of | **An echocardiogram should be obtained every three months while on therapy with anthracycline. Echocardiogram applies particularly to cases of high-risk acute promyelocytic leukemia, in which case the standard of care is to give anthracycline along with all-''[[trans]]'' [[retinoic acid]].<ref name="AvvisatiLo-Coco2011">{{cite journal|last1=Avvisati|first1=G.|last2=Lo-Coco|first2=F.|last3=Paoloni|first3=F. P.|last4=Petti|first4=M. C.|last5=Diverio|first5=D.|last6=Vignetti|first6=M.|last7=Latagliata|first7=R.|last8=Specchia|first8=G.|last9=Baccarani|first9=M.|last10=Di Bona|first10=E.|last11=Fioritoni|first11=G.|last12=Marmont|first12=F.|last13=Rambaldi|first13=A.|last14=Di Raimondo|first14=F.|last15=Kropp|first15=M. G.|last16=Pizzolo|first16=G.|last17=Pogliani|first17=E. M.|last18=Rossi|first18=G.|last19=Cantore|first19=N.|last20=Nobile|first20=F.|last21=Gabbas|first21=A.|last22=Ferrara|first22=F.|last23=Fazi|first23=P.|last24=Amadori|first24=S.|last25=Mandelli|first25=F.|title=AIDA 0493 protocol for newly diagnosed acute promyelocytic leukemia: very long-term results and role of maintenance|journal=Blood|volume=117|issue=18|year=2011|pages=4716–4725|issn=0006-4971|doi=10.1182/blood-2010-08-302950}}</ref> | ||
*'''MRI of the brain''': In rare cases, acute promyelocytic leukemia can present with central nervous system deficits.<ref name="pmid19608685">{{cite journal| author=Montesinos P, Díaz-Mediavilla J, Debén G, Prates V, Tormo M, Rubio V et al.| title=Central nervous system involvement at first relapse in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and anthracycline monochemotherapy without intrathecal prophylaxis. | journal=Haematologica | year= 2009 | volume= 94 | issue= 9 | pages= 1242-9 | pmid=19608685 | doi=10.3324/haematol.2009.007872 | pmc=2738716 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19608685 }} </ref> MRI of the brain is a useful to assess for lesions of the gray or white matter. | *'''Chest X-ray''': | ||
**[[Chest radiography]] is useful in the assessment of differentiation syndrome, which is a therapy-related complication when patients are treated with all-''[[trans]]'' [[retinoic acid]]. Chest X-ray will show pulmonary infiltrate and/or [[edema]].<ref name="pmid25116125">{{cite journal| author=Xu LM, Zheng YJ, Wang Y, Yang Y, Cao FF, Peng B et al.| title=Celastrol inhibits lung infiltration in differential syndrome animal models by reducing TNF-α and ICAM-1 levels while preserving differentiation in ATRA-induced acute promyelocytic leukemia cells. | journal=PLoS One | year= 2014 | volume= 9 | issue= 8 | pages= e105131 | pmid=25116125 | doi=10.1371/journal.pone.0105131 | pmc=4130635 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25116125 }} </ref> | |||
*'''MRI of the brain''': | |||
**In rare cases, acute promyelocytic leukemia can present with [[central nervous system]] deficits.<ref name="pmid19608685">{{cite journal| author=Montesinos P, Díaz-Mediavilla J, Debén G, Prates V, Tormo M, Rubio V et al.| title=Central nervous system involvement at first relapse in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and anthracycline monochemotherapy without intrathecal prophylaxis. | journal=Haematologica | year= 2009 | volume= 94 | issue= 9 | pages= 1242-9 | pmid=19608685 | doi=10.3324/haematol.2009.007872 | pmc=2738716 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19608685 }} </ref> | |||
**[[Magnetic resonance imaging|MRI]]<nowiki/>s of the brain is a useful to assess for [[Lesion|lesions]] of the [[Gray brain|gray]] or white matter. MRIs of the brain should be done if a patient has [[Neurology|neurological]] deficits. | |||
==References== | ==References== | ||
Latest revision as of 13:12, 11 April 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shyam Patel [2], Sogand Goudarzi, MD [3]; Grammar Reviewer: Natalie Harpenau, B.S.[4]
Overview
Additional imaging studies that can be useful in acute promyelocytic leukemia include echocardiogram, chest X-ray, and brain MRI.
Acute promyelocytic leukemia other imaging findings
- Echocardiogram:
- An echocardiogram is an essential imaging modality in patients with acute promyelocytic leukemia receiving anthracycline chemotherapy.[1]
- Patients who will be receiving anthracycline-based therapy require a baseline echocardiogram to assess the ejection fraction prior to therapy.[2]
- Anthracyclines are known to cause cardiac toxicity (specifically cardiomyopathy with cumulative anthracycline doses above 500mg/m2).[3]
- An echocardiogram should be obtained every three months while on therapy with anthracycline. Echocardiogram applies particularly to cases of high-risk acute promyelocytic leukemia, in which case the standard of care is to give anthracycline along with all-trans retinoic acid.[4]
- Chest X-ray:
- Chest radiography is useful in the assessment of differentiation syndrome, which is a therapy-related complication when patients are treated with all-trans retinoic acid. Chest X-ray will show pulmonary infiltrate and/or edema.[5]
- MRI of the brain:
- In rare cases, acute promyelocytic leukemia can present with central nervous system deficits.[6]
- MRIs of the brain is a useful to assess for lesions of the gray or white matter. MRIs of the brain should be done if a patient has neurological deficits.
References
- ↑ Neilan TG, Coelho-Filho OR, Pena-Herrera D, Shah RV, Jerosch-Herold M, Francis SA; et al. (2012). "Left ventricular mass in patients with a cardiomyopathy after treatment with anthracyclines". Am J Cardiol. 110 (11): 1679–86. doi:10.1016/j.amjcard.2012.07.040. PMC 3496816. PMID 22917553.
- ↑ McGowan JV, Chung R, Maulik A, Piotrowska I, Walker JM, Yellon DM (February 2017). "Anthracycline Chemotherapy and Cardiotoxicity". Cardiovasc Drugs Ther. 31 (1): 63–75. doi:10.1007/s10557-016-6711-0. PMC 5346598. PMID 28185035.
- ↑ Rahman AM, Yusuf SW, Ewer MS (2007). "Anthracycline-induced cardiotoxicity and the cardiac-sparing effect of liposomal formulation". Int J Nanomedicine. 2 (4): 567–83. PMC 2676818. PMID 18203425.
- ↑ Avvisati, G.; Lo-Coco, F.; Paoloni, F. P.; Petti, M. C.; Diverio, D.; Vignetti, M.; Latagliata, R.; Specchia, G.; Baccarani, M.; Di Bona, E.; Fioritoni, G.; Marmont, F.; Rambaldi, A.; Di Raimondo, F.; Kropp, M. G.; Pizzolo, G.; Pogliani, E. M.; Rossi, G.; Cantore, N.; Nobile, F.; Gabbas, A.; Ferrara, F.; Fazi, P.; Amadori, S.; Mandelli, F. (2011). "AIDA 0493 protocol for newly diagnosed acute promyelocytic leukemia: very long-term results and role of maintenance". Blood. 117 (18): 4716–4725. doi:10.1182/blood-2010-08-302950. ISSN 0006-4971.
- ↑ Xu LM, Zheng YJ, Wang Y, Yang Y, Cao FF, Peng B; et al. (2014). "Celastrol inhibits lung infiltration in differential syndrome animal models by reducing TNF-α and ICAM-1 levels while preserving differentiation in ATRA-induced acute promyelocytic leukemia cells". PLoS One. 9 (8): e105131. doi:10.1371/journal.pone.0105131. PMC 4130635. PMID 25116125.
- ↑ Montesinos P, Díaz-Mediavilla J, Debén G, Prates V, Tormo M, Rubio V; et al. (2009). "Central nervous system involvement at first relapse in patients with acute promyelocytic leukemia treated with all-trans retinoic acid and anthracycline monochemotherapy without intrathecal prophylaxis". Haematologica. 94 (9): 1242–9. doi:10.3324/haematol.2009.007872. PMC 2738716. PMID 19608685.