Acute promyelocytic leukemia other imaging studies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]
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). 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.[3]
- MRI of the brain: In rare cases, acute promyelocytic leukemia can present with central nervous system deficits.[4] 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.
- ↑ 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.
- ↑ 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.