A Case of Acute Promyelocytic Leukemia after Iodine-131 Treatment for Thyroid Cancer

Sang Hun Lee; Ki Seong Eom; Seok Lee; Hee-Je Kim; Chang-Ki Min; Sung Yong Kim; Byung Sik Cho; Hyuk Lee; Chan-Kwon Park; Seok-Goo Cho; Dong-Wook Kim; Jong-Wook Lee; Woo-Sung Min; Chun Choo Kim

doi:10.5045/kjh.2006.41.4.302

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

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Lee, Eom, Lee, Kim, Min, Kim, Cho, Lee, Park, Cho, Kim, Lee, Min, and Kim: A Case of Acute Promyelocytic Leukemia after Iodine-131 Treatment for Thyroid Cancer

Case Report

Korean J Hematol 2006;41(4):302-305.

Published online: 19 January 2006

DOI: https://doi.org/10.5045/kjh.2006.41.4.302

A Case of Acute Promyelocytic Leukemia after Iodine-131 Treatment for Thyroid Cancer

Sang Hun Lee¹, 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 Lee¹, Chan-Kwon Park¹, Seok-Goo Cho^1,², Dong-Wook Kim^1,², Jong-Wook Lee^1,², Woo-Sung Min^1,², Chun Choo Kim^1,²

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 E-mail: dreom@catholic.ac.kr

Received 5 June 2006 Revised 8 August 2006 Accepted 12 September 2006

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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

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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).

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