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==Acute promyelocytic leukemia other imaging findings== | ==Acute promyelocytic leukemia other imaging findings== | ||
*'''Echocardiogram''': An echocardiogram is an essential imaging modality in acute promyelocytic leukemia. Patients who will be receiving anthracycline-based therapy require a baseline echocardiogram to assess the ejection fraction prior to therapy. Anthracyclines are known to cause cardiac toxicity (specifically cardiomyopathy with cumulative anthracycline doses above 500mg/m2). 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. | *'''Echocardiogram''': 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. Anthracyclines are known to cause cardiac toxicity (specifically cardiomyopathy with cumulative anthracycline doses above 500mg/m2). 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. | ||
*'''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> | *'''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> MRI of the brain is a useful to assess for lesions of the gray or white matter. MRI is the brain should be done if a patient has neurological deficits. | *'''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. MRI is the brain should be done if a patient has neurological deficits. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]
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. Anthracyclines are known to cause cardiac toxicity (specifically cardiomyopathy with cumulative anthracycline doses above 500mg/m2). 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.
- 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.[2]
- MRI of the brain: In rare cases, acute promyelocytic leukemia can present with central nervous system deficits.[3] MRI of the brain is a useful to assess for lesions of the gray or white matter. MRI is 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.
- ↑ 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.