Letter R

Retinoic acid syndrome

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A syndrome that occurs from treatment with retinoic acid and is characterized by fever, dyspnea (difficulty breathing), chest pain, lung infiltrates evident on chest X-ray, pleural and pericardial effusions (fluid around the lungs and heart) and hypoxia (lack of oxygen).

The syndrome occurs within the first 3 weeks of retinoic acid treatment, for example, with the drug ATRA (all-trans retinoic acid) used in treating APL acute promyelocytic leukemia).

The retinoic acid syndrome involves the adhesion (sticking) of malignant cells in the pulmonary blood vessels.

Steroids, chemotherapy, and supportive measures can help.

The syndrome is a very serious complication.

About 10% of patients with the syndrome die of it.

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