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Ear involvement in acute promyelocytic leukemia at relapse: a disease-associated ‘sanctuary’?

Leukemia volume 16, pages 1127–1130 (2002)Cite this article

Abstract

Extramedullary (EM) involvement occurs infrequently in acute promyelocytic leukemia (APL) and usually involves skin and CNS. We describe seven patients (four observed at a single institution) who relapsed in various sites of the auditory apparatus, including the external canal and middle ear (temporal bone). Front-line treatment included ATRA and chemotherapy (six patients) or chemotherapy alone (one patient). Three patients had concomitant hematologic relapse, two had molecular relapse and two were in hematologic and molecular remission when ear localization was documented. Local symptoms that stimulated further diagnostic studies included ear bleeding/discharge in the first patient, but were mild in the others (hypoacusia, five patients; earache, two patients). Ear involvement by leukemia was documented by histological and/or molecular studies after local surgery in five cases, and by CT scan or NMR in the remaining patients. We suggest that the ear might represent a specific sanctuary for disease involvement in APL.

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Acknowledgements

This work was supported by ROMAIL Associazione Italiana contro le Leucemie, Sezione di Roma, and AIRC (Associazione Italiana per la Ricerca sul Cancro).

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Authors and Affiliations

  1. Department of Cellular Biotechnologies and Hematology, University La Sapienza, Rome, Italy

    M Breccia, MC Petti, AM Testi, D Diverio, A Romano, F Mandelli & F Lo Coco

  2. Department of Radiology, University La Sapienza, Rome, Italy

    V Guerrisi

  3. Department of Otorhinolaringology, University La Sapienza, Rome, Italy

    A Greco, ML Fiorella & M de Vincentiis

  4. Department of Hematology, University of Bari, Italy

    G Specchia

  5. Department of Hematology, Osp. ‘A Carolaretti’, Naples, Italy

    F Ferrara

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Breccia, M., Petti, M., Testi, A. et al. Ear involvement in acute promyelocytic leukemia at relapse: a disease-associated ‘sanctuary’?. Leukemia 16, 1127–1130 (2002). https://doi.org/10.1038/sj.leu.2402497

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