title: Transfusion-related acute lung injury (TRALI) during remission induction course of acute myeloid leukemia: a possible role for all-transretinoic-acid (ATRA)?
abstract: 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.
authors.affiliation: Hematology Department, Aziza Othmana University Hospital, place du gouvernement, La Kasbah, 1008, Tunis, Tunisia. ramzi.jed@voila.fr
authors.forename: R
authors.initials: R
authors.lastname: Jeddi
authors.forename: R
authors.initials: R
authors.lastname: Mansouri
authors.forename: K
authors.initials: K
authors.lastname: Kacem
authors.forename: E
authors.initials: E
authors.lastname: Gouider
authors.forename: H B
authors.initials: HB
authors.lastname: Abid
authors.forename: Z
authors.initials: Z
authors.lastname: Belhadjali
authors.forename: B
authors.initials: B
authors.lastname: Meddeb
mesh_terms: 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*
chemical_list: D000970:Antineoplastic Agents; D014212:Tretinoin