Bilateral osteonecrosis of the head of the femur during treatment with retinoic acid in a young patient with acute promyelocytic leukemia

• Published in: International journal of hematology Vol. 83; no. 3; pp. 252 - 253
• Main Authors: SAKAKURA, Miho, NISHII, Kazuhiro, USUI, Eiji, MONMA, Fumihiko, TSUKADA, Tetsuya, SHIKU, Hiroshi
• Format: Journal Article
• Language: English
• Published: Tokyo Springer 01.04.2006; Springer Nature B.V
• Subjects: Adult; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Biological and medical sciences; Diseases of the osteoarticular system; Female; Femur Head Necrosis - chemically induced; Femur Head Necrosis - diagnostic imaging; Hematologic and hematopoietic diseases; Humans; Leukemia, Promyelocytic, Acute - drug therapy; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Medical sciences; Radiography; Tretinoin - administration & dosage; Tretinoin - adverse effects; Vascular bone diseases; Human; Promyelocytic leukemia; Steroid; Femur; Head; Hematology; t(15;17); Acute; Retinoid; Diseases of the osteoarticular system; ATRA syndrome; Bilateral; Malignant hemopathy; Osteonecrosis; all-trans retinoic acid syndrome; Treatment; Retinoic acid; APL; M3 acute myelocytic leukemia
• ISSN: 0925-5710; 1865-3774
• DOI: 10.1532/IJH97.E0515

All-trans retinoic acid (ATRA) is the drug of choice for the treatment of acute promyelocytic leukemia (APL). In general, ATRA is well tolerated, but it does have side effects, the most severe of which is ATRA syndrome. We report the case of a young patient with APL treated with ATRA for induction and maintenance therapy who then developed avascular necrosis of both femoral heads. We also review cases of APL patients with osteonecrosis of the femoral head after ATRA therapy.