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.