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      All trans retinoic acid-induced bilateral disc edema in a case of acute promyelocytic leukemia

      case-report

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          Abstract

          An 18-year-old female presented with sudden onset bilateral vision loss. Extensive retinal hemorrhages were seen in both eyes. Systemic examination lead to a diagnosis of acute promyelocytic leukemia. The patient was treated with all trans retinoic acid (ATRA) and other medications in the induction phase. Bilateral disc edema was noted during the second consolidation cycle with ATRA. Complete resolution of bilateral disc edema was attained in three weeks’ time after discontinuing ATRA.

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          Acute promyelocytic leukemia current treatment algorithms

          Musa Yilmaz, Hagop Kantarjian, Farhad Ravandi (2021)
          In 1957, Hillestad et al. defined acute promyelocytic leukemia (APL) for the first time in the literature as a distinct type of acute myeloid leukemia (AML) with a “rapid downhill course” characterized with a severe bleeding tendency. APL, accounting for 10–15% of the newly diagnosed AML cases, results from a balanced translocation, t (15;17) (q22;q12-21), which leads to the fusion of the promyelocytic leukemia ( PML ) gene with the retinoic acid receptor alpha ( RARA ) gene. The PML–RARA fusion oncoprotein induces leukemia by blocking normal myeloid differentiation. Before using anthracyclines in APL therapy in 1973, no effective treatment was available. In the mid-1980s, all-trans retinoic acid (ATRA) monotherapy was used with high response rates, but response durations were short. Later, the development of ATRA, chemotherapy, and arsenic trioxide combinations turned APL into a highly curable malignancy. In this review, we summarize the evolution of APL therapy, focusing on key milestones that led to the standard-of-care APL therapy available today and discuss treatment algorithms and management tips to minimize induction mortality.
          Article 0 comments Cited 39 times – based on 0 reviews     Review now
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            Overview of all-trans-retinoic acid (ATRA) and its analogues: Structures, activities, and mechanisms in acute promyelocytic leukaemia.

            Chengyuan Liang, Guaiping Qiao, Yuzhi Liu … (2021)
            All-trans-retinoic acid (ATRA) is effective for preventing cancer and treating skin diseases and acute promyelocytic leukaemia (APL). These pharmacological effects of ATRA are mainly mediated by retinoid X receptors (RXRs) and retinoic acid receptors (RARs). This article provides a comprehensive overview of the clinical progress on and the molecular mechanisms of ATRA in the treatment of APL. ATRA can promote the transcriptional activation of differentiation-related genes and regulate autophagy by inhibiting mTOR, which results in anti-APL effects. In detail, the structures, pharmacological effects, and clinical studies of 68 types of ATRA analogues are described. These compounds have excellent antitumour therapeutic potential and could be used as lead compounds for further development and research.
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              Retinopathy in acute leukaemia at initial diagnosis: correlation of fundus lesions and haematological parameters.

              S Reddy, N. Jackson (2004)
              To determine the prevalence of retinal changes in newly diagnosed acute leukaemia patients, and to establish the relationship between retinal lesions and haematological parameters in these patients.
              Article 0 comments Cited 17 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Oman J Ophthalmol
                Journal ID (iso-abbrev): Oman J Ophthalmol
                Journal ID (publisher-id): OJO
                Journal ID (publisher-id): Oman J Ophthalmol
                Title: Oman Journal of Ophthalmology
                Publisher: Wolters Kluwer - Medknow (India )
                ISSN (Print): 0974-620X
                ISSN (Electronic): 0974-7842
                Publication date Collection: May-Aug 2024
                Publication date (Electronic): 27 June 2024
                Volume: 17
                Issue: 2
                Pages: 278-280
                Affiliations
                [1 ] Department of Ophthalmology, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
                [2 ] Department of Haematology, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
                Author notes
                Address for correspondence: Dr. Pradeep Kumar Panigrahi, Department of Ophthalmology, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan Deemed to be University, 8-Kalinga Nagar, Bhubaneswar - 751 003, Odisha, India. E-mail: doc.pkp25@ 123456gmail.com
                Article
                Publisher ID: OJO-17-278
                DOI: 10.4103/ojo.ojo_117_23
                PMC ID: 11309538
                SO-VID: 90e837e6-4dac-4ff6-8e24-12439d685449
                Copyright © Copyright: © 2024 Oman Ophthalmic Society
                License:

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                Date received : 04 June 2023
                Date revision received : 07 May 2024
                Date accepted : 16 May 2024
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: acute promyelocytic leukemia,all trans retinoic acid,bilateral,disc edema
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: acute promyelocytic leukemia, all trans retinoic acid, bilateral, disc edema

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