BILATERAL OSTEONECROSIS OF THE HEAD OF THE FEMUR COMPLICATING ACUTE PROMYELOCYTIC LEUKEMIA - A SEQUEL TO TREATMENT OF RETINOIC ACID SYNDROME WITH DEXAMETHASONE

The complication of 'retinoic acid syndrome' occurs in 25-30% of patie nts with acute promyelocytic leukemia (APL) treated with all-transreti noic acid (ATRA). Early dexamethasone therapy has reduced mortality fr om this complication. No long-term sequel of the syndrome or its treat ment with dexamethasone has been described. We report a patient with A PL treated with ATRA who developed avascular necrosis of both femoral heads following treatment of retinoic acid syndrome with short-duratio n, high-dose dexamethasone.