ATRA Syndrome:10 year experience

Abstract

Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia (AML) responsible for 10% of all AMLs. Usually, the treatment of APL consists of chemotherapy and all-trans retinoic acid (ATRA) administration. The major side effect of ATRA is the socalled "ATRA syndrome", which has an incidence of nearly 30%. We studied the clinical presentation and the incidence of ATRA syndrome in patients with APL admitted to Hospital São Paulo-UNIFESP-EPM. Thirteen patients with APL received ATRA. ATRA syndrome was diagnosed in 5 patients (38%) with a mean age of 29 years old, which were, in average, in the 10th day of the use of ATRA. The most frequent clinical findings were respiratory distress, pulmonary infiltrate on chest X-Ray and fever. This report calls attention to the need of early diagnosis of the syndrome with prompt introduction of dexamethasone at the first sign in order to obtain therapeutic success.