"All-trans-retinoic acid (ATRA) syndrome, is the more common cause of differentiation syndrome 8. Acute promyelocytic leukaemia (APL) cells respond to therapeutic levels of this normal plasma derivative of vitamin A by maturating into normal granulocytes which can cause capillary leakage and organ damage 1."
"Without prompt treatment with corticosteroids, the mortality of all-trans-retinoic acid syndrome is about 25% 1. Early intervention with high dose corticosteroids is effective, and those most at risk are given steroid prophylaxis. Acute myeloid leukaemia treated with differentiation agents has a lower mortality rate compared to acute promyelocytic leukaemia treated with ATRA."
"All-trans-retinoic acid syndrome was first described in 1991 by Frankel et al. 1-3,7."
"pleural effusion(s)"
"Differentiation syndrome is related to the rapid increase in mature granulocytes over several days resulting in vascular adherence and organ infiltration. Cytokine release can cause capillary leak, haemorrhage and organ failure and these effects can be blocked by corticosteroids. Mortality can be as high as 25% and is commonly due to heart failure, acute respiratory distress syndrome, pulmonary haemorrhage and renal failure 1."
"Differentiation syndrome occurs approximately 7 days after treatment initiation with features of fever, congestive heart failure, fluid-retention, respiratory distress, haemorrhage, thrombosis and renal failure."