Acute Promyelocytic Leukemia After Treatment of Metastatic Castration-Resistant Prostate Cancer With Radium-223

The administration of injected radioactive treatments such as radium-224 and strontium-89 used for treatment of various diseases has previously been linked with leukemogenic potential. Radium-223, an alpha-emitting radioactive isotope used as a second-line treatment for castration-resistant prostate cancer with bony metastases, has not been shown to be a risk factor for acute leukemia. In this case report we describe a patient who developed acute promyelocytic leukemia after radium-223 administration. To our knowledge, this is the first report of such a case, but causality is not established especially because of the relatively short duration of time between radium-223 exposure and the diagnosis of leukemia. (C) 2016 Elsevier Inc. All rights reserved.