BONE-MARROW NECROSIS FOLLOWING ALL-TRANS-RETINOIC ACID THERAPY FOR ACUTE PROMYELOCYTIC LEUKEMIA

Acute promyelocytic leukaemia (APL) (FAB-M3) is associated with fatal haemorrhagic complications in 10 to 20% of patients. Recently ALL-Tran s Retinoic acid (ALL-Trans RA) therapy has been used with rapid correc tion of the coagulopathy. Although minimal haematologic toxicity has b een reported, a number of potentially serious side-effect have been de scribed. We report a case of bone marrow necrosis occurring in a patie nt with APL treated with ALL-Trans RA. The possible relationship of th is complication to retinoid therapy is discussed. This patient subsequ ently recovered and not only achieved complete remission but tolerated two cycles of chemotherapy without problems.