Transfusion-related acute lung injury (TRALI) during remission induction course of acute myeloid leukemia: a possible role for all-transretinoic-acid (ATRA)?
Transfusion-related acute lung injury (TRALI) is a clinical syndrome characterized by sudden onset of respiratory distress due to pulmonary edema during or following transfusion. Two proposed pathophysiologic mechanisms for TRALI were proposed: the antibody hypothesis and the two-event hypothesis. The two-event hypothesis postulates that a pathway to neutrophil activation and aggregation can occur without leukocyte antibodies. We report a case of TRALI occurring during remission induction course of acute myeloid leukemia in a 27-year-old woman who received All-transretinoic-acid (ATRA). We postulate that ATRA may have played a role in this life-threatening complication by priming neutrophil and enhancing their adherence and their activation in the pulmonary endothelium. TRALI improved with non-invasive ventilation support and use of high dose corticosteroids.
Jeddi
R
R
Hematology Department, Aziza Othmana University Hospital, place du gouvernement, La Kasbah, 1008, Tunis, Tunisia. ramzi.jed@voila.fr
Mansouri
R
R
Kacem
K
K
Gouider
E
E
Abid
H B
HB
Belhadjali
Z
Z
Meddeb
B
B
D000328:Adult; D000740:Anemia / Q000209:etiology; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D007964:Leukocytosis / Q000209:etiology*; D012074:Remission Induction / Q000379:methods; D012128:Respiratory Distress Syndrome / Q000209:etiology; D065227:Transfusion Reaction; D014212:Tretinoin / Q000627:therapeutic use*
D000970:Antineoplastic Agents; D014212:Tretinoin