Journal List > Korean J Hematol > v.41(4) > 1032691

Korean J Hematol. 2006 Dec;41(4):302-305. Korean.
Published online December 31, 2006.  https://doi.org/10.5045/kjh.2006.41.4.302
Copyright © 2006 Korean Society of Hematology; Korean Society of Blood and Marrow Transplantation; Korean Society of Pediatric Hematology-Oncology; Korean Society on Thrombosis and Hemostasis
A Case of Acute Promyelocytic Leukemia after Iodine-131 Treatment for Thyroid Cancer
Sang Hun Lee,1 Ki Seong Eom,1,2 Seok Lee,1,2 Hee-Je Kim,1,2 Chang-Ki Min,1,2 Sung Yong Kim,1,2 Byung Sik Cho,1,2 Hyuk Lee,1 Chan-Kwon Park,1 Seok-Goo Cho,1,2 Dong-Wook Kim,1,2 Jong-Wook Lee,1,2 Woo-Sung Min,1,2 and Chun Choo Kim1,2
1Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Korea.
2Catholic HSCT Center, Seoul, Korea.

Correspondence to: Ki Seong Eom, M.D. Division of Hematology, St. Mary's Hospital, The Catholic University of Korea, Catholic HSCT Center, 62, Yeouido-dong, Yeongdeungpo-gu, Seoul 150-713, Korea. Tel: +82-2-3779-1043, Fax: +82-2-780-3132, Email: dreom@catholic.ac.kr
Received June 05, 2006; Revised August 08, 2006; Accepted September 12, 2006.

Abstract

Radioactive iodine (131I) has been used in the treatment of thyroid cancer to eliminate residual thyroid tissue after thyroidectomy and to treat metastatic disease. Leukemia has rarely been reported as a late complication of 131I therapy, occurring most frequently after receiving a cumulative activity of 800 mCi of the radioisotope. Although FAB M3 type (acute promyelocytic leukemia, APL) as the secondary acute leukemia had been rarely reported, recently there have been a few cases of therapy-related APL leukemia seen. We hereby report a case of secondary acute promyelocytic leukemia occurring in a patient who received radioactive iodine therapy for papillary thyroid carcinoma. An assessment of causality using the Naranjo probability scale showed that a possible relationship existed between APL seen in the patient and the use of the radioactive iodine. Although this is a very rare event, strict hematologic follow-up of patients treated with radioactive iodine may be warranted, along with a high index of suspicion in those with coagulopathy.

Keywords: Acute promyelocytic leukemia; Radioactive iodine; Secondary AML

Figures


Fig. 1
Bone marrow aspiration findings shows leukemic cells showing medium to large sized, round to oval or irregularly shaped, finely chromatinated nuclei with or without distinct nucleoli, and moderate amount of blue cytoplasm with numerous azurophilic granules (×1,000).
Click for larger image

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