Pancreatitis in Acute Promyelocytic Leukemia: Drug‑induced or Differentiation Syndrome?

Dibyendu De; Uttam Kumar Nath; Prantar Chakrabarti

doi:10.4103/ijmpo.ijmpo_36_16

Indian Journal of Medical and Paediatric Oncology, Table of Contents

CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2017; 38(03): 371-373
DOI: 10.4103/ijmpo.ijmpo_36_16

Case Report

Pancreatitis in Acute Promyelocytic Leukemia: Drug‑induced or Differentiation Syndrome?

Authors

Dibyendu De

Department of Hematology and Hemato-Oncology, The Mission Hospital, Durgapur, West Bengal, India
Uttam Kumar Nath

Department of Hematology, Institute of Hematology and Transfusion Medicine, Medical College, Kolkata, West Bengal, India
Prantar Chakrabarti

Department of Hematology, NRS Medical College, Kolkata, West Bengal, India

Abstract

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Abstract

Acute promyelocytic leukemia (APL) constitutes about 15% of all acute myeloid leukemia patients and can now be treated even without any chemotherapy, with all-trans-retinoic acid (ATRA) and arsenic trioxide (ATO). Acute pancreatitis (AP) is a rare adverse event in APL, which is primarily reported to be secondary to hypertriglyceridemia. Here, we have reported AP developed in a patient of APL, during induction with ATRA and ATO, but it was not associated with hypertriglyceridemia. Rather, it was associated with respiratory distress and weight gain, coincidental leukocytosis, bilateral pleural effusion, and edematous pancreatitis without any necrosis. Hence, AP in this case is diagnosed to be a manifestation of differentiation syndrome, and it responded to steroid.

Keywords

Acute promyelocytic leukemia - all-trans-retinoic acid - arsenic - differentiation syndrome - pancreatitis

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References

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