Wa. Lester et al., Respiratory failure during induction chemotherapy for acute myelomonocyticleukaemia (FAB M4Eo) with Ara-C and all-trans retinoic acid, BR J HAEM, 109(4), 2000, pp. 847-850
We report two cases of acute myeloid leukaemia FAB classification M4Eo with
high white cell counts at presentation, who developed acute respiratory fa
ilure with pulmonary infiltrates on chest radiograph soon after commencing
conventional cytotoxic chemotherapy plus all-trans retinoic acid (ATRA). We
suggest that in patients with M4Eo ATRA should be used with caution, perha
ps delaying its commencement until the white cell count is < 10 x 10(9)/l.