Leukemia cutis and all-trans retinoic acid–induced myocarditis in acute promyelocytic leukemia

TL;DR

This paper reports a rare case of APL with skin involvement and heart inflammation caused by treatment, highlighting the need for careful diagnosis and personalized care.

Contribution

The paper presents a unique case combining leukemia cutis and ATRA-induced myocarditis in APL, both rare occurrences.

Findings

A 36-year-old male with low-risk APL developed leukemia cutis and ATRA-induced myocarditis.

Such combined manifestations are exceedingly rare, with each condition having fewer than 50 published cases.

The case emphasizes the importance of individualized treatment and comprehensive evaluation in APL.

Abstract

Acute promyelocytic leukemia (APL) is frequently curable in the modern era using the chemotherapy-free regimen of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). However, rare disease manifestations and treatment complications may threaten these outcomes by requiring intensification or abbreviation of therapy. We present a unique case of a 36-year-old male with newly diagnosed low-risk APL with biopsy-confirmed leukemia cutis and isolated ATRA-associated myocarditis during induction therapy. Both APL leukemia cutis and ATRA-associated myocarditis are exceedingly rare, with each having less than 50 published cases to date. This report offers a comprehensive review of the literature, underscoring the importance of a comprehensive diagnostic evaluation and individualized care to ensure outstanding long-term outcomes for patients with APL.

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