ATRA (all-trans-retinoic acid) Syndrome in Acute Promyelocytic Leukemia: Clinical and Radiologic Findings.
10.3348/jkrs.2001.44.3.339
- Author:
Keon Ha KIM
1
;
Jin Mo GOO
;
Jung Gi IM
;
Myung Jin CHUNG
;
Kyung Hyun DO
;
Joon Beom SEO
;
Seon yang PARK
Author Information
1. Deparment of Radiology, Seoul National University College of Medicine.
- Publication Type:Original Article
- Keywords:
Lung, radiography;
Lung, effects of drugs on
- MeSH:
Cough;
Dyspnea;
Early Diagnosis;
Female;
Fever;
Humans;
Leukemia, Promyelocytic, Acute*;
Male;
Pleural Effusion;
Prednisolone;
Prognosis;
Radiography;
Retrospective Studies;
Thorax;
Tretinoin
- From:Journal of the Korean Radiological Society
2001;44(3):339-343
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To describe the clinical and radiologic findings of all-trans-retinoic acid (ATRA) syndrome in acute promyelocytic leukemia. MATERIALS AND METHODS: Among 21 patients with acute promyelocytic leukemia who were treated with all-trans- retinoic acid between 1995 and 1998, we retrospectively evaluated the cases of four with ATRA syn-drome. Two were male and two were female, and their mean age was 58 years. The clinical and radiologic findings of chest radiography (n=4) and HRCT (n=1) were analyzed. RESULTS: Between seven and 13 days after ATRA treatment, dry cough, dyspnea and high fever developed in all patients. The WBC count in peripheral blood was significantly higher [2.9 -25.3(mean, 10.8)-fold] than before ATRA treatment, and in all patients, chest radiography revealed ill-defined consolidation and pleural effu-sion. Kerley 's B line (n=3) and hilar enlargement (n=3) were also seen, and in one patient, HRCT demonstrated septal line thickening. Among four patients treated with prednisolone and Ara-C,three recovered and one CONCLUSION: In acute promyelocytic patients treated with all-trans-retinoic acid, radiologic findings of ill-de-fined consolidation, pleural effusion, hilar prominence and Kerley 's B line may suggest ATRA syndrome. The early diagnosis of this will improve the patients' prognosis.
