title: Exacerbation of coagulopathy with concurrent bone marrow necrosis, hepatic and renal dysfunction secondary to all-trans retinoic acid therapy for acute promyelocytic leukemia.
abstract: A 22-year-old female presented with acute promyelocytic leukemia (APL). Treatment with all-trans retinoic acid (ATRA) resulted in a severe exacerbation of the coagulopathy 5 days after its introduction. This was complicated by bone marrow necrosis, parenchymal liver damage and acute tubular necrosis. Temporary cessation of the drug and subsequent dose reduction was effective in controlling the coagulopathy.
authors.affiliation: Medical Research Centre, City Hospital, Nottingham, U.K.
authors.forename: G M
authors.initials: GM
authors.lastname: Cull
authors.forename: J W
authors.initials: JW
authors.lastname: Eikelboom
authors.forename: P K
authors.initials: PK
authors.lastname: Cannell
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001778:Blood Coagulation Disorders / Q000097:blood / Q000139:chemically induced*; D001853:Bone Marrow / Q000473:pathology*; D056486:Chemical and Drug Induced Liver Injury; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000139:chemically induced*; D015473:Leukemia, Promyelocytic, Acute / Q000097:blood / Q000188:drug therapy*; D008107:Liver Diseases / Q000097:blood; D009336:Necrosis; D014212:Tretinoin / Q000009:adverse effects* / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D014212:Tretinoin