Document Detail


Retinoic acid syndrome. Recognition, prevention and management.
MedLine Citation:
PMID:  9565738     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The introduction of treatment with tretinoin (all-trans retinoic acid) and its combination with antineoplastic therapy has improved the outcome of acute promyelocytic leukaemia (APL). Retinoic acid syndrome is the major adverse effect of tretinoin and it occurs in about 25% of treated APL patients in the absence of prophylactic measures and is often fatal. Generally, the retinoic acid syndrome is associated with increasing leucocyte counts and is probably caused by the release of several cytokines by maturing blast cells. The retinoic acid syndrome gives a clinical picture of bodyweight gain, respiratory distress, serous effusions and cardiac and renal failure. Adequate prophylaxis, based on the addition to tretinoin of dexamethasone and also, according to most authors, antineoplastic therapy (in case of rapidly increasing leucocyte counts) has decreased the incidence of retinoic acid syndrome to about 15%. Most importantly, these measures have reduced its mortality to about 1% of all treated patients.
Authors:
P Fenaux; S De Botton
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Drug safety : an international journal of medical toxicology and drug experience     Volume:  18     ISSN:  0114-5916     ISO Abbreviation:  Drug Saf     Publication Date:  1998 Apr 
Date Detail:
Created Date:  1998-06-11     Completed Date:  1998-06-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9002928     Medline TA:  Drug Saf     Country:  NEW ZEALAND    
Other Details:
Languages:  eng     Pagination:  273-9     Citation Subset:  IM    
Affiliation:
Service des Maladies du Sang, CHU, Lille, France.
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MeSH Terms
Descriptor/Qualifier:
Anti-Inflammatory Agents / therapeutic use*
Antineoplastic Agents / adverse effects*
Clinical Trials as Topic
Cytokines / metabolism*
Dexamethasone / therapeutic use*
Heart Failure / chemically induced,  prevention & control
Humans
Infant, Newborn
Kidney Failure / chemically induced,  prevention & control
Leukemia, Promyelocytic, Acute / complications,  drug therapy
Leukocyte Count / drug effects
Respiratory Distress Syndrome, Newborn / chemically induced,  prevention & control
Syndrome
Tretinoin / adverse effects*
Weight Gain / drug effects
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Antineoplastic Agents; 0/Cytokines; 302-79-4/Tretinoin; 50-02-2/Dexamethasone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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