Acute myeloid leukemia after liver transplantation

doi:10.3969/j.issn.2095-4344.2013.44.009

Abstract

Abstract:

BACKGROUND: Acute myeloid leukemia after liver transplantation is a rare complication with high mortality.
OBJECTIVE: To study the clinical features of acute myeloid leukemia after liver transplantation.
METHODS: One case of acute promyelocytic leukemia after liver transplantation was reported, and literatures were reviewed.
RESULTS AND CONCLUSION: Case presentation was post-odontectomy bleeding with associative abnormal coagulation test at 85 months after liver transplantation. Routine blood test, bone marrow test and chromosome analysis and examination diagnosed as acute promyelocytic leukemia and promyelocytic leukemia/RARα positive chimeric gene, and clearly diagnosed as acute promyelocytic leukemia combined with disseminated intravascular coagulation. The patient received fresh frozen plasma transfusion to correct the abnormal coagulation, and then received induction chemotherapy with retinoic acid, arsenic trioxide and daunorubicin to obtain bone marrow complete remission. The patient was treated with daunorubicin combined with cytarabine and mitoxantrone combined with cytarabine regimens after remission induction to consolidate the chemotherapy for two courses of treatment, and then subsequently subjected to arsenous acid chemotherapy, and the bone marrow was sustained for remission. During chemotherapy, the dose and type of immunosuppressive agents were adjusted, and the patient had stable liver function without serious infection or complications. The results indicate that acute myeloid leukemia is common and often occurs after liver transplantation. When the patient displays hematological abnormality, acute promyelocytic leukemia should be considered. Early diagnosis and treatment can reduce the mortality.

Key words: liver transplantation, leukemia, myeloid, immunosuppressive agents, disseminated intravascular coagulation

CLC Number:

R617

Liu Ming-juan, Liu Li-hui, Shi Bing, Ye Li-ping, Zhang Yong-qing. Acute myeloid leukemia after liver transplantation[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(44): 7709-7714.

References

[1]Penn I. Posttransplant maglinacies. Transplant Proc.1999; 31(1-2):1260-1262.
[2]Penn I. Occurrence of cancers in immunosuppressed organ transplant recipients. Clin Transpl.1998;147-158.
[3]Jiang N, Li H, Wang GS, et al.Acute leukemia, a rare but fatal complication after liver transplantation. Leuk Res.2009; (33): 1349-1351.
[4]Thalhammer SR, Wieselthales G, Knoebl P, et al. Post-transplant acute myeloid leukemia(PT-AML). Leukemia. 1999;13(3):321-326.
[5]Silliman CC, Tyson RW, Wei Q, et al.Acute Philadelphia chromosome-positive leukemia in an adolescent boy after liver transplantation. J Pediatric Hematology Oncology. 2003; 25(7):565-568.
[6]Camós M, Esteve J, Rimola A,et al.Increased incidence of acute myeloid leukemia after liver transplantation? Description of three new cases and review of the literature. Transplantation.2004; (77):311-313.
[7]Doti CA, Gondolesi GE, Sheiner PA, et al.Leukemia after liver transplant. Transplantation.2001; (72):1643-1646.
[8]Cho YU, Chi HS, Park CJ, et al.Two cases of post-liver transplant acute myeloid leukemia in Korean adults: review of bibliographies and comparison with post-renal transplant acute myeloid leukemia. Ann Hematol.2008; (87):513-514.
[9]Bodó I, Peters M, Radich JP, et al.Donor-derived acute promyelocytic leukemia in a liver-transplant recipient. N Engl J Med.1999; (341):807-813.
[10]Sato T, Kobayashi R, Iguchi A, et al.Acute promyelocytic leukemia after living donor partial orthotopic liver transplantation in two Japanese girls. Leuk Lymphoma. 2005; (46):1057-1060.
[11]Thalhammer-Scherrer R, Wieselthaler G, Knoebl P, et al.Post-transplant acute myeloid leukemia (PT-AML). Leukemia. 1999; (13):321-326.
[12]Zhang GS, Dai CW, Peng HL, et al.Myelodysplastic syndrome with transformation to acute monocytic leukemia with FLT3-ITD mutation following orthotopic liver transplantation. Leuk Res.2006; (30):908-910.
[13]Saigal S, Norris S, Muiesan P, et al.Evidence of differential risk for posttransplantation malignancy based on pretransplantation cause in patients undergoing liver transplantation. Liver Transpl.2002; (8):482-487.
[14]Dantal J, Soulillou JP.Immunosuppressive drugs and the risk of cancer after organ transplantation. N Engl J Med.2005; (352):1371-1373.
[15]Zavos G, Bokos J, Papaconstantinou J, et al.Study of “de novo” malignancies among Greek renal transplant recipients.Transplant Proc.2003;35:1399-1403.
[16]Rascente M, Pisani F,barletta A,et al.Malignancies after kidney transplantation. Transplant Proc.2005;37:2529- 2531.
[17]Helen R, Urwin,Peter W,et al.Predicting risk of non-melanoma skin cancer and prealignant skin lesions in renal transplant recipients. Transplantation.2009;87(8):1667-1671.
[18]Huebner G, karhaus M, Pethig K, et al. Myelodysplastic syndrome and acute myelogenous leukemia secondary to heart transplantation. Transplantation.2000;70(4):688-690.
[19]Shihab FS, Bennett WM, ISAAC J,et al.Nitic oxide modulates vascular endothelial growth factor and receptors in chronic cyctosporine nephrolocicily. Kidney Int.2003;63(2):522-533.
[20]Green M, Miehaels MG, Katz BZ, et al. CMV-IVIG for prevention of Epstein Barr virus disease and post-transplant lymphoproliferative disease in pediatric liver transplant recipients. Am J Transplant. 2006;6(8):1906-1912.
[21]Henry DD, Hunger SP, Braylan RC, et al. Low viral load post-transplant lymphoproliferative disease localized within the tongue. Transplant Infect Dis. 2008;10(6):426-430.
[22]De Sanjose S, Mbisa G, Perez-Alvarea S, et al. Geographic variation in the prevalence of Kaposi sarcoma-associated herpesvirus and risk factors for transmission. J Infect Dis. 2009;199(10):1449-1456.
[23]Piselli P, Busnaeh G, Citterio F, et al. Risk of Kaposi sarcoma after solid-organ transplantation: multicenter study in 4767 recipients in Italy. Transplant Proc. 2009;41(4): 1227-1230.
[24]Nordin P, Hansson BG, Hansson C, et al. Human papilloma virus in skin, mouth and uterine cervix in female renal transplant recipients with or without a history of cutaneous squamous cell carcinoma. Acta Derm venereol. 2007; 83(3): 219-222.
[25]Lye WC. Successful treatment of Epstein-Barr virus-associated T-cell cutaneous lymphoma in a renal allograft recipient case report and review of the literature. Transplant Proc. 2000;32(7):1988-1989.
[26]Saltzman EA, Guay AT, Jacobson J. Improvement in erectile function in men with organic erectile dysfunction by correction of elevated cholesterol levels: a clinical observation. J Urol. 2004;172(1):255-258.
[27]Hanahan D, Weinberg RA. The hallmarks of cancer. Cell. 2000;100(1):57-70.
[28]Giordano TP, Henderson L, Landgren O, et al.Risk of non-hodgkin lymphoma and lymphoproliferative precursor diseases in US veterans with hepatitis C virus. JAMA. 2007;297(18):2010-2017.
[29]Végso G, Sebestyén A, Paku S, et al.Antiproliferative and apoptotic effects of mycophenolic acid in human B-cell non-Hodgkin lymphomas. Leuk Res.2007; 31(7):1003-1008.
[30]Barozzi P, Riva G, Vallerini D, et al.Indirect antitumor effects of mammalian target of rapamycin inhibitors against Kaposi sarcoma in transplant patients. Transplantation.2009; 88(4): 597-598.
[31]Boratynska M, Watorek E, Smolska D, et al. Anticancer effect of airolimus in renal allograft recipients with de novo malignancies. Transplant Proc. 2007;39(9):2736-2739.
[32]Crespo-Leiro MC, Alonso-Pulpon L, Vazquez de Prada JA, et al. Malignancy after heart transplantation: incidence, progosis and risk factors. Am J Transplant. 2008;8(5):1031-1039.
[33]Floryk D, Thompson TC.Antiproliferative effects of AVN944, a novel inosine 5-monophosphate dehydrogenase inhibitor, in prostate cancer cells. Int J Cancer. 2008;123(10):2294-2302.
[34]Wright DG, Boosalis M, Malek K, et al. Effects of the IMP-dehydrogenase inhibitor, tiazofurin, in bcr-abl positive acute myelogenous leukemia. in vitro studies. Leuk Res. 2004;28(11):1137-1143.
[35]Szekeres T, Sedlak J, Novotny I. Benzamide riboside, a recent inhibitor of inosine 5-monophosphate dehydrogenase induces transferring receptors in cancer cells. Curr Med Chem. 2002;9(7):759-764.
[36]Geissler EK, Schlitt HJ, Thomas G. Cancer and transplantation. Am J Transplantation. 2008,8(11):2212-2218.
[37]Yu Wang, Qiu Zhao, Songlin Ma, et al. Sirolimus inhibits human pancreatic carcinoma cell proliferation by a mechanism linked to targeting of mTOR/HIF-1 Alpha/VEGF signaling. IUBMB Life. 2007, 59(11):717-721.
[38]Guba M, Yezhelyev M, Eiubhorn ME, et al. Rapamycin induces tumor-apecille thrombosis via tissue factor in the presence of VEGF. Blood. 2005;105(11):4463-4469.
[39]Markus G, Gudrun EK, Evelun N, et al. Dosing of rapamycin is critical to achieve an optimal antiangiogenic effect agaist cancer. Transplant Int.2005;18(1):8.
[40]Toso C, Merani S, David L ,et al. Sirolimus-based immunosuppression is associated with increased survival after liver transplantation for heparocellular carcinoma. Hepatology.2010;51(4):1237-1243.