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Hyperleukocytosis complicating lonafarnib treatment in patients with chronic myelomonocytic leukemia

Leukemia volume 19, pages 308–310 (2005)Cite this article

TO THE EDITOR

The leukemia differentiation syndrome is a potentially life threatening complication of all-trans-retinoic acid (ATRA) treatment for acute promyelocytic leukemia (APL) characterized by fever, leukocytosis, hypoxemia with interstitial pulmonary infiltrates, weight gain, serosal effusions, and prompt response to treatment with corticosteroids.1 Although the pathogenesis of the syndrome is unclear, laboratory investigations indicate that ATRA promotes inflammatory cytokine generation by APL cells and activates homotypic and heterotypic adhesion, thereby enhancing endovascular permeability and promoting leukemia cell adhesion and transmembrane migration.2, 3 Initially termed the retinoic acid syndrome, subsequent studies revealed that the analogous syndrome may occur in APL patients treated with arsenic trioxide,4 and rarely in patients with non-promyelocytic subtypes of acute myeloid leukemia treated with ATRA.5

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Authors and Affiliations

  1. Departments of Medicine and Pathology, The Arizona Cancer Center, University of Arizona College of Medicine, Tucson, AZ, USA

    A Buresh, L Rimsza, S Kurtin, R Heaton & A List

  2. University of Cincinnati and Children's Hospital, Cincinnati, OH, USA

    J Perentesis

  3. Hematologic Malignancy Program, Department of Interdisciplinary Oncology, H Lee Moffitt Cancer Center and Research Institute at the University of South Florida, Tampa, FL, USA

    R Heaton & A List

  4. Schering-Plough Research Institute, Schering-Plough Corporation, Kenilworth, NJ, USA

    M Sugrue

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  1. A Buresh
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Correspondence to A List.

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Buresh, A., Perentesis, J., Rimsza, L. et al. Hyperleukocytosis complicating lonafarnib treatment in patients with chronic myelomonocytic leukemia. Leukemia 19, 308–310 (2005). https://doi.org/10.1038/sj.leu.2403569

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