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Case Report

Late Differentiation Syndrome in Acute Promyelocytic Leukemia: A Challenging Diagnosis

1
Hematology Service, Hospital Santo António, Porto, Spain
2
Hematology Service, Hospital Universitário, Paseo San Vicente, 88-182, 37007 Salamanca, Spain
*
Author to whom correspondence should be addressed.
Hematol. Rep. 2014, 6(4), 5654; https://doi.org/10.4081/hr.2014.5654
Submission received: 30 September 2014 / Revised: 10 October 2014 / Accepted: 22 October 2014 / Published: 19 November 2014

Abstract

Detailed knowledge about differentiation syndrome (DS) has remained limited. There are 2 large studies conducted by the Spanish workgroup PETHEMA (Programa Español de Tratamientos en Hematología; Spanish Program on Hematology Treatments) and the European group trial (LPA 96-99 and APL 93) in which the incidence, characteristics, prognostic factors and outcome of patients developing DS are evaluated. Both have described the median time of DS development between 10 and 12 days. The severity of the DS has been evaluated in the study conducted by PETHEMA, and severe DS usually occurs at the beginning of the treatment (median of 6 days), as compared with moderate DS (median of 15 days). We report here in two cases of late severe DS, with late diagnosis due to both time and form of presentation. We discuss the physiopathology, clinical presentation, prophylaxis and treatment of DS.
Keywords: differentiation syndrome; acute promyelocytic leukemia; all trans retinoic acid differentiation syndrome; acute promyelocytic leukemia; all trans retinoic acid

Share and Cite

MDPI and ACS Style

Cabral, R.; Caballero, J.C.; Alonso, S.; Dávila, J.; Cabrero, M.; Caballero, D.; Vásquez, L.; Sánchez-Guijo, F.; López, L.; Cañizo, M.C.; et al. Late Differentiation Syndrome in Acute Promyelocytic Leukemia: A Challenging Diagnosis. Hematol. Rep. 2014, 6, 5654. https://doi.org/10.4081/hr.2014.5654

AMA Style

Cabral R, Caballero JC, Alonso S, Dávila J, Cabrero M, Caballero D, Vásquez L, Sánchez-Guijo F, López L, Cañizo MC, et al. Late Differentiation Syndrome in Acute Promyelocytic Leukemia: A Challenging Diagnosis. Hematology Reports. 2014; 6(4):5654. https://doi.org/10.4081/hr.2014.5654

Chicago/Turabian Style

Cabral, Renata, Juan Carlos Caballero, Sara Alonso, Julio Dávila, Monica Cabrero, Dolores Caballero, Lourdes Vásquez, Fermin Sánchez-Guijo, Lucia López, Maria C. Cañizo, and et al. 2014. "Late Differentiation Syndrome in Acute Promyelocytic Leukemia: A Challenging Diagnosis" Hematology Reports 6, no. 4: 5654. https://doi.org/10.4081/hr.2014.5654

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