Pseudotumour cerebri in acute promyelocytic leukemia on treatment with all-trans-retinoic acid (ATRA) - an experience from a tertiary care centre
- Author:
Manzoor Ahmad Tali
;
Yasir Bashir
;
Shuaeb Bhat
;
Fahim Manzoor
;
Nusrat Bashir
;
Sajad Geelani
;
Javid Rasool
;
Abdul Waheed Mir
- Publication Type:Journal Article
- Keywords:
all-trans retinoic acid;
anthracycline;
differentiation;
pseudotumour cerebri
- From:The Malaysian Journal of Pathology
2015;37(2):141-144
- CountryMalaysia
- Language:English
-
Abstract:
Acute promyelocytic leukemia (APML) is considered to be sensitive to all-trans-retinoic acid
(ATRA) which acts as a differentiating agent. ATRA is considered to be a well-tolerated agent
and is known to achieve complete remission in acute promyelocytic leukemia. However, a few
cases on long term all-trans-retinoic acid (ATRA) use can develop pseudotumor cerebri. Out of
32 patients with APML who were treated in our Centre over a 4-year-period, we encountered 6
patients who developed ATRA-related pseudotumor cerebri while on maintenance treatment. The
patients ranged from 12 to 40 years of age. 3 patients complained of unbearable headache, 2 of
diplopia and 1 of gross reduction in visual acuity. CT scans and MRI did not reveal any intracranial
lesions. Cerebrospinal fluid (CSF) examination was normal with CSF manometry revealing a high
CSF pressure (average of 345mmH2O). Fundoscopy revealed papilledema in 5 patients and optic
atrophy in 1 patient. The patients were successfully managed with decrease dose/discontinuation
of ATRA, use of acetazolamide, corticosteroids and therapeutic CSF drainage.
- Full text:P020150923583108201175.pdf
