Introduction
Acute promyelocytic leukemia (APL) is an aggressive type of acute myeloid leukemia (AML) associated with severe hemorrhagic syndromes and thrombotic problems [1]. This disorder is related to a reciprocal chromosomal translocation t(15;17)(q24;q21) involving retinoic acid receptor α (RARα) and its fusion partners including promyelocytic leukemia (PML) and promyelocytic leukemia zinc finger (PLZF), which leads to the PML‐RARα chimeric gene formation [2]. This chromosomal translocation occurs between the long arm of chromosome 15, with a breakpoint at 15q24, and the long arm of chromosome 17, with a breakpoint at 17q21, which results in the lack of normal white and red blood cells and platelets in the body [1, 3]. There is an abnormal accumulations of immature blood-forming cells (promyelocytes) in the blood and bone marrow (BM). Unlike other forms of AML, APL is well treated by all-trans retinoic acid (ATRA; also known as tretinoin) therapy, as a criteria to distinguish this disorder from other forms of AML [4].
In most cases, ATRA therapy is well tolerated and its toxicity is modest. Hyperleukocytosis and the retinoic acid syndrome are two known complications. However, other side effects have been reported for APL including cheilosis, hypertriglyceridaemia, headache, bone pain, pseudotumour cerebri, skin dryness, and mucous membranes [5]. They are typically short-term and simply controlled by other therapeutic approaches [3, 6].
In this report, we reported a relatively uncommon side effect observed in a patient with APL during ATRA treatment.