Open AccessPancreatitis in acute promyelocytic leukemia: Drug-induced or differentiation syndrome?
Author(s) -
Dibyendu De,
Uttam Kumar Nath,
Prantar Chakrabarti
Publication year - 2017
Publication title -
indian journal of medical and paediatric oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.229
H-Index - 22
eISSN - 0975-2129
pISSN - 0971-5851
DOI - 10.4103/ijmpo.ijmpo_36_16
Subject(s) - medicine , acute promyelocytic leukemia , leukocytosis , acute pancreatitis , pancreatitis , arsenic trioxide , gastroenterology , ards , hypertriglyceridemia , myeloid leukemia , pleural effusion , leukemia , cytarabine , retinoic acid , lung , cholesterol , apoptosis , biochemistry , chemistry , triglyceride , gene
Acute promyelocytic leukemia (APL) constitutes about 15% of all acute myeloid leukemia patients and can now be treated even without any chemotherapy, with all-trans-retinoic acid (ATRA) and arsenic trioxide (ATO). Acute pancreatitis (AP) is a rare adverse event in APL, which is primarily reported to be secondary to hypertriglyceridemia. Here, we have reported AP developed in a patient of APL, during induction with ATRA and ATO, but it was not associated with hypertriglyceridemia. Rather, it was associated with respiratory distress and weight gain, coincidental leukocytosis, bilateral pleural effusion, and edematous pancreatitis without any necrosis. Hence, AP in this case is diagnosed to be a manifestation of differentiation syndrome, and it responded to steroid.