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Case Reports in Hematology
Volume 2015, Article ID 826894, 3 pages
Case Report

Acute Promyelocytic Leukemia Presenting with Severe Marrow Fibrosis

1Indiana University Simon Cancer Center, Indianapolis, IN, USA
2Eli Lilly and Company, Indianapolis, IN, USA

Received 20 May 2015; Accepted 29 June 2015

Academic Editor: Eduardo Arellano-Rodrigo

Copyright © 2015 Harsh Shah et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We report a case of acute promyelocytic leukemia (APL) presenting with severely fibrotic marrow. There are four other reports of similar cases in the literature. Our patient was treated with All-Transretinoic Acid- (ATRA-) containing induction chemotherapy, followed by consolidation and maintenance therapy. He achieved a complete morphologic remission with adequate count recovery in a timely fashion, and later a molecular remission was documented. The patient remains in molecular remission and demonstrates normal blood counts now more than 4 years after induction. Since the morphological appearance may not be typical and the bone marrow may not yield an aspirate for cytogenetic analysis, awareness of such entity is important to make a correct diagnosis of this potentially curable disease.