About 2%-27% of patients with acute promyelocytic leukemia (APL) when put on therapy with differentiating agents like all-trans retinoic acid (ATRA) or arsenic trioxide (ATO) develop DS 7-12 days after initiation of therapy. Why this syndrome develops in some of the patients?
Dego and De Santis (2011) write as follows: "DS pathogenesis is not completely understood, but it is believed that an excessive inflammatory response is the main phenomenon involved, which results in increased production of chemokines and expression of adhesion molecules on APL cells. Due to the high morbidity and mortality associated with DS, its recognition and the prompt initiation of the treatment is of utmost importance. Dexamethasone is considered the mainstay of treatment of DS, and the recommended dose is 10 mg twice daily by intravenous route until resolution of DS. In severe cases (respiratory or acute renal failure) it is recommended the discontinuation of ATRA or ATO until recovery. "
Thanks S. Béatrice Marianne Ewalds-Kvist for your valued contribution.
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