Korean J Hematol.  2006 Jun;41(2):105-109. 10.5045/kjh.2006.41.2.105.

Low-dose All-trans Retinoic Acid for Remission Induction of Acute Promyelocytic Leukemia in Acute Renal Failure

• Park HW
• Choi JH
• Lee D
• Koo DH
• Koo JE
• Kim SH
• Lee JH
• Lee JH
• Lee KH

• KMID: 2083484
• DOI: http://doi.org/10.5045/kjh.2006.41.2.105

Abstract

All-trans retinoic acid (ATRA) is the standard induction treatment for acute promyelocytic leukemia (APL). Renal involvement sometimes necessitates a dose reduction or discontinuation of induction therapy for hematological malignancies. We report here on a case of APL that achieved complete remission with low-dose ATRA treatment despite the patient's acute renal failure. A 42-year-old woman presented with a 2 month history of ecchymosis and she was subsequently diagnosed with APL. During induction treatment with ATRA and idarubicin, oliguria developed and her azotemia rapidly progressed. Because of the progressive deterioration in her general condition, the patient was transferred to the intensive care unit. We started renal replacement therapy for her acute renal failure and we discontinued ATRA treatment. Her urine output started to increase, and there was an improvement in the patient's general condition. We resumed low-dose ATRA treatment. She achieved complete remission after 52 days of treatment.

Keyword

All-trans retinoic acid; Renal insufficiency; Acute promyelocytic leukemia

MeSH Terms

Acute Kidney Injury*
Adult
Azotemia
Ecchymosis
Female
Hematologic Neoplasms
Humans
Idarubicin
Intensive Care Units
Leukemia, Promyelocytic, Acute*
Oliguria
Remission Induction*
Renal Insufficiency
Renal Replacement Therapy
Tretinoin*
Idarubicin
Tretinoin

Figure

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  Fig. 1 The time course of change of BUN and creatinine during remission induction therapy.

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  Fig. 2 The time course of change of amylase and lipase during remission induction therapy.

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