THROMBOTIC COMPLICATIONS IN ACUTE PROMYELOCYTIC LEUKEMIA DURING ALL-TRANS-RETINOIC ACID THERAPY

A case of acute renal failure, due to occlusion of renal vessels in a patient with acute promyelocytic leukemia (APL) treated with all-trans -retinoic acid (ATRA) and tranexamic acid has been described recently. We report a case of acute renal failure in an APL patient treated wit h ATRA alone. This case further supports the concern about thromboembo lic complications associated with ATRA therapy in APL patients. The pa tient, a 43-year-old man, presented all the signs and symptoms of APL and was included in a treatment protocol with ATRA. After 10 days of t reatment, he developed acute renal failure that was completely reversi ble after complete remission of APL was achieved and therapy discontin ued. We conclude that ATRA is a valid therapeutic choice for patients with APL, although the procoagulant tendency is not completely correct ed. Thrombotic events, however, could be avoided by using low-dose hep arin.