ALL-TRANS-RETINOIC ACID (ATRA) RESPONSIVE SKIN RELAPSES OF ACUTE PROMYELOCYTIC LEUKEMIA FOLLOWED BY ATRA-INDUCED PSEUDOTUMOR CEREBRI

A 30-year-old woman with acute promyelocytic leukaemia (APL) went into complete remission following idarubicin and cytarabine chemotherapy; 18 months later she developed repeated skill relapse, with no bone mar row involvement. DNA and RNA analysis of skin lesions revealed the pre sence of the PML/RAR alpha hybrid gene. which was not detected at the same time in bone marrow. The skin relapses were successfully treated by all-trans-retinoic acid (ATRA) as single agent over 2 years, Howeve r, prolonged administration of ATRA caused pseudotumour cerebri, which disappeared upon drug withdrawal, The absence of the hybrid gene in t he bone marrow by RT-PCR analysis led to the patient being autografted .