Differentiation syndrome in non-M3 acute myeloid leukemia treated with the retinoid X receptor agonist bexarotene.
Differentiation Syndrome, also known as all-trans retinoic acid (ATRA) syndrome, is a well-described clinical phenomenon occurring in patients with the M3 subtype of acute myeloid leukemia receiving ATRA chemotherapy. Bexarotene is a novel synthetic compound that selectively binds and activates retinoic X receptors, a subclass of retinoid receptors not targeted by ATRA. We report a patient with refractory non-M3 acute promyelocytic leukemia (AML) who developed differentiation syndrome during bexarotene monotherapy. This case emphasizes the importance of monitoring for differentiation syndrome among patients receiving retinoid therapies and demonstrates the ability of bexarotene to stimulate differentiation of leukemic blasts.
DiNardo
Courtney D
CD
Department of Internal Medicine, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA.
Ky
Bonnie
B
Vogl
Dan T
DT
Forfia
Paul
P
Loren
Alison
A
Luger
Selina
S
Mato
Anthony
A
Tsai
Donald E
DE
D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000077610:Bexarotene; D002454:Cell Differentiation; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000139:chemically induced; D047488:Retinoid X Receptors / Q000819:agonists*; D013577:Syndrome; D013764:Tetrahydronaphthalenes / Q000009:adverse effects* / Q000627:therapeutic use
D000970:Antineoplastic Agents; D047488:Retinoid X Receptors; D013764:Tetrahydronaphthalenes; D000077610:Bexarotene