A Rare Case of Acute Promyelocytic Leukemia with ider(17)(q10)t(15;17)(q22;q21) and FLT3-ITD Mutation.

BACKGROUND

Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia characterized by the t(15;17)(q22;q21) translocation. Although it typically responds well to therapy, certain genetic aberrations, including ider(17)(q10)t(15;17)(q22;q21) and FLT3-ITD mutations, have unclear prognostic implications.

METHODS

A 61-year-old female patient presented with dizziness and persistent bruising. Laboratory and imaging studies revealed coagulopathy and intracranial hemorrhage. Morphological, immunophenotypic, cytogenetic, molecular, and FISH analyses confirmed APL with both ider(17)(q10)t(15;17)(q22;q21) and FLT3-ITD mutation.

RESULTS

Despite standard ATRA and idarubicin induction therapy, there was no improvement in leukemic burden, and the patient succumbed to worsening hemorrhage one week after emergency surgery.

CONCLUSIONS

This case of APL with coexisting ider(17) and FLT3-ITD mutations exhibited an aggressive course and resistance to standard treatment. These findings suggest that such patients may require intensified therapeutic strategies and closer monitoring.