Acute renal failure associated with the retinoic acid syndrome in acute promyelocytic leukemia Journal Article


Authors: Flombaum, C. D.; Isaacs, M.; Reich, L.; Berman, E.; Warrell, R. P.
Article Title: Acute renal failure associated with the retinoic acid syndrome in acute promyelocytic leukemia
Abstract: All-trans-retinoic acid is an effective agent to induce remission in patients with acute promyelocytic leukemia (APL). Unlike conventional chemotherapy, this drug exerts its effect by inducing differentiation of immature leukemic cells. A distinctive clinical syndrome characterized by fever, dyspnea, effusions, weight gain, and organ failure (the 'retinoic acid syndrome') can occur during treatment with this drug. Postmortem studies have shown extensive organ infiltration by leukemic cells, and the early administration of corticosteroids can result in prompt resolution of symptoms. We describe a patient with APL in whom acute renal failure developed during treatment with all-trans-retinoic acid. Transient renal enlargement during a period of leukocytosis and a beneficial response to treatment with dexamethasone suggest that renal failure in this patient was probably related to the retinoic acid syndrome.
Keywords: adult; case report; disease association; creatinine; dexamethasone; acute kidney failure; acute myeloblastic leukemia; lactate dehydrogenase; gentamicin; corticosteroid; retinoic acid; nitrogen; intravenous drug administration; fibrinogen; oral drug administration; leukemia remission; phosphorus; acute promyelocytic leukemia; urea; fibrin degradation product; retinoic acid syndrome; all-trans-retinoic acid; acute renal failure; human; male; article; aztreonam; ticarcillin
Journal Title: American Journal of Kidney Diseases
Volume: 27
Issue: 1
ISSN: 0272-6386
Publisher: W.B. Saunders Co.  
Date Published: 1996-01-01
Start Page: 134
End Page: 137
Language: English
DOI: 10.1016/s0272-6386(96)90041-4
PUBMED: 8546128
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 22 November 2017 -- Source: Scopus
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MSK Authors
  1. Lilian M Reich
    99 Reich
  2. Ellin Berman
    173 Berman
  3. Raymond P Warrell
    175 Warrell
  4. Marian Isaacs
    7 Isaacs