Recurrent differentiation syndrome or septic shock? Unresolved dilemma in a patient with acute promyelocytic leukemia.

Jeddi Ramzi (1) , Ghedira Hela (2) , Ben Amor Ramzi (2) , Menif Samia (3) , Belhadjali Zaher (2) , Meddeb Balkis (2)

1 Hematology Department, Aziza Othmana University Hospital, Tunis, Tunisia
2 Hematology Department
3 Laboratoire d'Hématologie, Institut Pasteur de Tunis

Differentiation syndrome (DS) is a life-threatening complication observed in patients with acute promyelocytic leukemia (APL) receiving induction therapy with all-trans-retinoic acid (ATRA). A bimodal incidence of DS has been observed, with a majority of cases occurring during the first week of ATRA treatment ("early" DS), but a substantial number of cases occurring during the third or even fourth week of ATRA treatment ("late" DS). However, to our knowledge occurrence of both early and late DS in the same patient has not been reported. We report an APL patient treated with the AIDA regimen, who experienced both early and late DS, a situation where differential diagnosis was difficult.

Domaines: Médecine humaine et pathologie

Jeddi Ramzi, Ghedira Hela, Ben Amor Ramzi, Menif Samia, Belhadjali Zaher, et al.. Recurrent differentiation syndrome or septic shock? Unresolved dilemma in a patient with acute promyelocytic leukemia.. Medical oncology and tumor pharmacotherapy, 2011, 28 (1), pp.279-81. ⟨10.1007/s12032-010-9462-y⟩. ⟨pasteur-00646591⟩