Extensive splenic infarction, deep vein thrombosis and pulmonary emboli complicating induction therapy with all-trans-retinoic acid (ATRA) for acute promyelocytic leukemia.
Bleeding is a common complication during initial induction treatment for acute promyelocytic leukemia (APL). Administration of all-trans-retinoic acid (ATRA), which is in routine use for APL in the past decade improves the bleeding tendency dramatically. Nevertheless, thrombotic events have still been reported in a small proportion of APL patients treated with ATRA. Here we describe a case of splenic infarction and life threatening thrombosis in a young patient with APL treated with ATRA. We review the relevant literature and discuss the pathophysiology, risk factors and treatment of this complication occurring during therapy, for APL.
Goldschmidt
Neta
N
Department of Hematology, Hadassah University Hospital, Kiryat Hadassah, P.O. Box 12000, Jerusalem 91120, Israel.
Gural
Alexander
A
Ben Yehuda
Dina
D
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000150:complications* / Q000188:drug therapy; D008297:Male; D011655:Pulmonary Embolism / Q000139:chemically induced* / Q000188:drug therapy; D012074:Remission Induction / Q000379:methods; D013159:Splenic Infarction / Q000139:chemically induced*; D013577:Syndrome; D019851:Thrombophilia / Q000097:blood / Q000209:etiology; D014212:Tretinoin / Q000009:adverse effects* / Q000627:therapeutic use; D020246:Venous Thrombosis / Q000139:chemically induced* / Q000188:drug therapy
D000925:Anticoagulants; D014212:Tretinoin