Journal of Oncology Pharmacy Practice

 

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Journal of Oncology Pharmacy Practice, Vol. 10, No. 3, 149-154 (2004)
DOI: 10.1191/1078155204jp128oa

Retinoic acid syndrome after one dose of all-transretinoic acid

Marisa Battistella, BSc Phm, PharmD

Pharmacy Department, University Health Network, Toronto, Ontario, Canada

Lisa D Burry, BSc Phm, PharmD, FCCP

Pharmacy Department, Mount Sinai Hospital, Toronto, Ontario, Canada

Jack T Seki, BSc, PharmD

Pharmacy Department, University Health Network, Toronto, Ontario, Canada

All-trans-retinoic acid (ATRA) is typically used as a first line agent in the treatment of acute promyelocytic leukaemia (APL), achieving complete remission (CR) rates (incombination with chemotherapy) of about 90%. One of the drawbacks of the use of ATRA is that up to 30% of patients can present with retinoic acid syndrome (RAS), which can be fatal in some patients. We describe a case of RAS after only one dose of ATRA, which to our knowledge has not previously been identified in the literature. The pathophysiology and treatment of APL is presented. A clinical description of RAS is outlined, and an evaluation of risk factors for developing RAS is reviewed.

Key Words: acute promyelocytic leukaemia • alltrans-retinoic acid • dexamethasone • retinoic acid syndrome


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