[Effective methyl prednisolone pulse therapy for a patient with retinoic acid syndrome in acute promyelocytic leukemia].
A 46-year-old woman with acute promyelocytic leukemia (APL) was treated with all-trans retinoic acid (ATRA) and chemotherapy according to the AML-92, M3 regimen of the Japan Adult Leukemia Study Group (JALSG). Between days 7 and 18 of therapy, she suffered chest discomfort, fever, cough, dyspnea and general fatigue. A chest roentogenogram showed bilateral interstitial infiltrates. Her leukocyte count began to increase rapidly to 6,400/microliters on day 14. Marked hypoxia (PO2 35.9 mmHg) suggested occurrence of retinoic acid (RA) syndrome. She underwent endotracheal intubation and mechanical ventilation with administration of methyl-prednisolone (m-PSL) pulse therapy. Her symptoms promptly abated. Therapy with ATRA was continued and her leukocyte count reached 44,800/microliters on day 19 of therapy. She achieved complete remission on day 48.
Matsuda
S
S
Center for Hematopoietic Disorders, Ohta Nishinouchi Hospital.
Saitoh
Y
Y
Kanbayashi
H
H
Tanaka
T
T
Sakuma
H
H
Maruyama
Y
Y
Ohno
R
R
D004417:Dyspnea / Q000139:chemically induced*; D005260:Female; D005334:Fever / Q000139:chemically induced; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy*; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D012074:Remission Induction; D013577:Syndrome; D014212:Tretinoin / Q000009:adverse effects* / Q000627:therapeutic use
D014212:Tretinoin; D008775:Methylprednisolone