[Severe side effects of the treatment of acute promyelocytic leukemia with all-trans retinoic acid].
Sixty-three cases with acute promyelocytic leukemia (APL) were treated with all-trans retinoic acid (ATRA). The rates of hyperleukocytosis, intracranial hypertension, retinoic acid syndrome were 57.1%, 9.5%, and 3.2% respectively. Mortality of the treatment was 11.1%. Under ATRA treatment, hyperleukocytosis leading to leukostasis was the cause of death in patients with APL. We therefore suggest that the patients with such leukocyte levels (that is, 5.0 x 10(9).L-1 on the 6th day, 10.0 x 10(9).L-1 on the 10th day, 15.0 x 10(9).L-1 on the 15th day) can be used as guidelines for starting chemotherapy(homoharringtonine); before ATRA treatment, while leukocyte counts are > 10 x 10(9).L-1, the patients only receive homoharringtonine; when leukocyte counts are < or = 5.0 x 10(9).L-1, the patients receive a combination of homoharringtonine and ATRA. Retinoic acid syndrome is a distinctive complication of ATRA therapy in the patients with APL. While the syndrome occurs, the treatment of ATRA must be stopped and corticosteroids must be used.
Han
Z P
ZP
Department of Hematology, Second Affiliated Hospital, Hunan Medical University, Changsha 410011.
Lu
H B
HB
Shen
Z S
ZS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D006248:Harringtonines / Q000008:administration & dosage; D000077863:Homoharringtonine; D006801:Humans; D019586:Intracranial Hypertension / Q000139:chemically induced*; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy*; D007955:Leukemoid Reaction / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D014212:Tretinoin / Q000009:adverse effects*
D000970:Antineoplastic Agents; D006248:Harringtonines; D014212:Tretinoin; D000077863:Homoharringtonine