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APL Differentiation Syndrome

MedGen UID:
163654
•Concept ID:
C0860564
•
Disease or Syndrome
Synonym: Retinoic Acid Syndrome

Definition

A syndrome observed in patients with acute promyelocytic leukemia treated with all-trans retinoic acid. It is characterized by weight gain, dyspnea, pleural and pericardial effusions, leukocytosis, and renal failure. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVAPL Differentiation Syndrome

Professional guidelines

PubMed

Management of acute promyelocytic leukemia: updated recommendations from an expert panel of the European LeukemiaNet.
Sanz MA, Fenaux P, Tallman MS, Estey EH, Löwenberg B, Naoe T, Lengfelder E, Döhner H, Burnett AK, Chen SJ, Mathews V, Iland H, Rego E, Kantarjian H, Adès L, Avvisati G, Montesinos P, Platzbecker U, Ravandi F, Russell NH, Lo-Coco F
Blood 2019 Apr 11;133(15):1630-1643. Epub 2019 Feb 25 doi: 10.1182/blood-2019-01-894980. PMID: 30803991Free PMC Article
Treatment of patients with acute promyelocytic leukemia: a consensus statement on risk-adapted approaches to therapy.
Tallman M, Douer D, Gore S, Powell BL, Ravandi F, Rowe J, Ranganathan A, Sanz MA
Clin Lymphoma Myeloma Leuk 2010 Oct;10 Suppl 3:S122-6. doi: 10.3816/CLML.2010.s.023. PMID: 21115429
Arsenic trioxide: safety issues and their management.
Au WY, Kwong YL
Acta Pharmacol Sin 2008 Mar;29(3):296-304. doi: 10.1111/j.1745-7254.2008.00771.x. PMID: 18298894

Recent clinical studies

Etiology

ATRA treatment slowed P-selectin-mediated rolling of flowing HL60 cells in a mechano-chemical-dependent manner.
Dong X, Peng S, Ling Y, Huang B, Tu W, Sun X, Li Q, Fang Y, Wu J
Front Immunol 2023;14:1148543. Epub 2023 Apr 24 doi: 10.3389/fimmu.2023.1148543. PMID: 37168856Free PMC Article
The impact of ICAM-1, CCL2 and TGM2 gene polymorphisms on differentiation syndrome in acute promyelocytic leukemia.
Mohammadzadeh Z, Omidkhoda A, Chahardouli B, Hoseinzadeh G, Moghaddam KA, Mousavi SA, Rostami S
BMC Cancer 2021 Jan 9;21(1):46. doi: 10.1186/s12885-021-07783-y. PMID: 33422029Free PMC Article
Management of acute promyelocytic leukemia: updated recommendations from an expert panel of the European LeukemiaNet.
Sanz MA, Fenaux P, Tallman MS, Estey EH, Löwenberg B, Naoe T, Lengfelder E, Döhner H, Burnett AK, Chen SJ, Mathews V, Iland H, Rego E, Kantarjian H, Adès L, Avvisati G, Montesinos P, Platzbecker U, Ravandi F, Russell NH, Lo-Coco F
Blood 2019 Apr 11;133(15):1630-1643. Epub 2019 Feb 25 doi: 10.1182/blood-2019-01-894980. PMID: 30803991Free PMC Article
Management of acute promyelocytic leukemia: recommendations from an expert panel on behalf of the European LeukemiaNet.
Sanz MA, Grimwade D, Tallman MS, Lowenberg B, Fenaux P, Estey EH, Naoe T, Lengfelder E, Büchner T, Döhner H, Burnett AK, Lo-Coco F
Blood 2009 Feb 26;113(9):1875-91. Epub 2008 Sep 23 doi: 10.1182/blood-2008-04-150250. PMID: 18812465
Treatment of acute promyelocytic leukemia by retinoids.
Fenaux P, Wang ZZ, Degos L
Curr Top Microbiol Immunol 2007;313:101-28. doi: 10.1007/978-3-540-34594-7_7. PMID: 17217041

Diagnosis

The impact of ICAM-1, CCL2 and TGM2 gene polymorphisms on differentiation syndrome in acute promyelocytic leukemia.
Mohammadzadeh Z, Omidkhoda A, Chahardouli B, Hoseinzadeh G, Moghaddam KA, Mousavi SA, Rostami S
BMC Cancer 2021 Jan 9;21(1):46. doi: 10.1186/s12885-021-07783-y. PMID: 33422029Free PMC Article
Management of acute promyelocytic leukemia: updated recommendations from an expert panel of the European LeukemiaNet.
Sanz MA, Fenaux P, Tallman MS, Estey EH, Löwenberg B, Naoe T, Lengfelder E, Döhner H, Burnett AK, Chen SJ, Mathews V, Iland H, Rego E, Kantarjian H, Adès L, Avvisati G, Montesinos P, Platzbecker U, Ravandi F, Russell NH, Lo-Coco F
Blood 2019 Apr 11;133(15):1630-1643. Epub 2019 Feb 25 doi: 10.1182/blood-2019-01-894980. PMID: 30803991Free PMC Article
Arsenic trioxide - An old drug rediscovered.
Emadi A, Gore SD
Blood Rev 2010 Jul-Sep;24(4-5):191-9. Epub 2010 May 15 doi: 10.1016/j.blre.2010.04.001. PMID: 20471733Free PMC Article
Management of acute promyelocytic leukemia: recommendations from an expert panel on behalf of the European LeukemiaNet.
Sanz MA, Grimwade D, Tallman MS, Lowenberg B, Fenaux P, Estey EH, Naoe T, Lengfelder E, Büchner T, Döhner H, Burnett AK, Lo-Coco F
Blood 2009 Feb 26;113(9):1875-91. Epub 2008 Sep 23 doi: 10.1182/blood-2008-04-150250. PMID: 18812465
Arsenic trioxide: new clinical experience with an old medication in hematologic malignancies.
Douer D, Tallman MS
J Clin Oncol 2005 Apr 1;23(10):2396-410. doi: 10.1200/JCO.2005.10.217. PMID: 15800332

Therapy

The impact of ICAM-1, CCL2 and TGM2 gene polymorphisms on differentiation syndrome in acute promyelocytic leukemia.
Mohammadzadeh Z, Omidkhoda A, Chahardouli B, Hoseinzadeh G, Moghaddam KA, Mousavi SA, Rostami S
BMC Cancer 2021 Jan 9;21(1):46. doi: 10.1186/s12885-021-07783-y. PMID: 33422029Free PMC Article
Management of acute promyelocytic leukemia: updated recommendations from an expert panel of the European LeukemiaNet.
Sanz MA, Fenaux P, Tallman MS, Estey EH, Löwenberg B, Naoe T, Lengfelder E, Döhner H, Burnett AK, Chen SJ, Mathews V, Iland H, Rego E, Kantarjian H, Adès L, Avvisati G, Montesinos P, Platzbecker U, Ravandi F, Russell NH, Lo-Coco F
Blood 2019 Apr 11;133(15):1630-1643. Epub 2019 Feb 25 doi: 10.1182/blood-2019-01-894980. PMID: 30803991Free PMC Article
Arsenic trioxide - An old drug rediscovered.
Emadi A, Gore SD
Blood Rev 2010 Jul-Sep;24(4-5):191-9. Epub 2010 May 15 doi: 10.1016/j.blre.2010.04.001. PMID: 20471733Free PMC Article
Management of acute promyelocytic leukemia: recommendations from an expert panel on behalf of the European LeukemiaNet.
Sanz MA, Grimwade D, Tallman MS, Lowenberg B, Fenaux P, Estey EH, Naoe T, Lengfelder E, Büchner T, Döhner H, Burnett AK, Lo-Coco F
Blood 2009 Feb 26;113(9):1875-91. Epub 2008 Sep 23 doi: 10.1182/blood-2008-04-150250. PMID: 18812465
Arsenic trioxide: safety issues and their management.
Au WY, Kwong YL
Acta Pharmacol Sin 2008 Mar;29(3):296-304. doi: 10.1111/j.1745-7254.2008.00771.x. PMID: 18298894

Prognosis

Characteristics and predictors of early hospital deaths in newly diagnosed APL: a 13-year population-wide study.
Gill H, Yung Y, Chu HT, Au WY, Yip PK, Lee E, Yim R, Lee P, Cheuk D, Ha SY, Leung RYY, Ma ESK, Kumana CR, Kwong YL
Blood Adv 2021 Jul 27;5(14):2829-2838. doi: 10.1182/bloodadvances.2021004789. PMID: 34269798Free PMC Article
The impact of ICAM-1, CCL2 and TGM2 gene polymorphisms on differentiation syndrome in acute promyelocytic leukemia.
Mohammadzadeh Z, Omidkhoda A, Chahardouli B, Hoseinzadeh G, Moghaddam KA, Mousavi SA, Rostami S
BMC Cancer 2021 Jan 9;21(1):46. doi: 10.1186/s12885-021-07783-y. PMID: 33422029Free PMC Article
In vitro studies on the role of recombinant human soluble thrombomodulin in the context of retinoic acid mediated APL differentiation syndrome.
Kojima S, Nishioka C, Chi S, Yokoyama A, Ikezoe T
Leuk Res 2017 Dec;63:1-9. Epub 2017 Oct 18 doi: 10.1016/j.leukres.2017.10.003. PMID: 29055789
Acute promyelocytic leukemia in patients aged >70 years: the cure beyond the age.
Finsinger P, Breccia M, Minotti C, Carmosino I, Girmenia C, Chisini M, Volpicelli P, Vozella F, Romano A, Montagna C, Colafigli G, Cimino G, Avvisati G, Petti MC, Lo-Coco F, Foà R, Latagliata R
Ann Hematol 2015 Feb;94(2):195-200. Epub 2014 Sep 4 doi: 10.1007/s00277-014-2197-7. PMID: 25186786
Treatment of acute promyelocytic leukemia by retinoids.
Fenaux P, Wang ZZ, Degos L
Curr Top Microbiol Immunol 2007;313:101-28. doi: 10.1007/978-3-540-34594-7_7. PMID: 17217041

Clinical prediction guides

Characteristics and predictors of early hospital deaths in newly diagnosed APL: a 13-year population-wide study.
Gill H, Yung Y, Chu HT, Au WY, Yip PK, Lee E, Yim R, Lee P, Cheuk D, Ha SY, Leung RYY, Ma ESK, Kumana CR, Kwong YL
Blood Adv 2021 Jul 27;5(14):2829-2838. doi: 10.1182/bloodadvances.2021004789. PMID: 34269798Free PMC Article
Acute promyelocytic leukemia in patients aged >70 years: the cure beyond the age.
Finsinger P, Breccia M, Minotti C, Carmosino I, Girmenia C, Chisini M, Volpicelli P, Vozella F, Romano A, Montagna C, Colafigli G, Cimino G, Avvisati G, Petti MC, Lo-Coco F, Foà R, Latagliata R
Ann Hematol 2015 Feb;94(2):195-200. Epub 2014 Sep 4 doi: 10.1007/s00277-014-2197-7. PMID: 25186786
Treatment of patients with acute promyelocytic leukemia: a consensus statement on risk-adapted approaches to therapy.
Tallman M, Douer D, Gore S, Powell BL, Ravandi F, Rowe J, Ranganathan A, Sanz MA
Clin Lymphoma Myeloma Leuk 2010 Oct;10 Suppl 3:S122-6. doi: 10.3816/CLML.2010.s.023. PMID: 21115429
The expression of p38, ERK1 and Bax proteins has increased during the treatment of newly diagnosed acute promyelocytic leukemia with arsenic trioxide.
Mandegary A, Hosseini R, Ghaffari SH, Alimoghaddam K, Rostami S, Ghavamzadeh A, Ghahremani MH
Ann Oncol 2010 Sep;21(9):1884-1890. Epub 2010 Feb 17 doi: 10.1093/annonc/mdq034. PMID: 20164150
Induction of CXC and CC chemokines by all-trans retinoic acid in acute promyelocytic leukemia cells.
Shibakura M, Niiya K, Niiya M, Asaumi N, Yoshida C, Nakata Y, Tanimoto M
Leuk Res 2005 Jul;29(7):755-9. Epub 2005 Feb 26 doi: 10.1016/j.leukres.2005.01.005. PMID: 15927671

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