tretinoin and Transfusion-Reaction

Transfusion-related acute lung injury (TRALI) is a clinical syndrome characterized by sudden onset of respiratory distress due to pulmonary edema during or following transfusion. Two proposed pathophysiologic mechanisms for TRALI were proposed: the antibody hypothesis and the two-event hypothesis. The two-event hypothesis postulates that a pathway to neutrophil activation and aggregation can occur without leukocyte antibodies. We report a case of TRALI occurring during remission induction course of acute myeloid leukemia in a 27-year-old woman who received All-transretinoic-acid (ATRA). We postulate that ATRA may have played a role in this life-threatening complication by priming neutrophil and enhancing their adherence and their activation in the pulmonary endothelium. TRALI improved with non-invasive ventilation support and use of high dose corticosteroids.

Topics: Adult; Anemia; Antineoplastic Agents; Female; Flow Cytometry; Humans; Leukemia, Myeloid, Acute; Leukocytosis; Remission Induction; Respiratory Distress Syndrome; Transfusion Reaction; Tretinoin

Topics: Adult; Catheterization, Central Venous; Critical Illness; Factor VII; Factor VIIa; Female; Femoral Artery; Hemorrhage; Humans; Leukemia, Promyelocytic, Acute; Recombinant Proteins; Transfusion Reaction; Tretinoin

Topics: Adult; DNA, Neoplasm; Hepatitis C; Humans; Leukemia, Promyelocytic, Acute; Male; Receptors, Retinoic Acid; Transfusion Reaction; Translocation, Genetic; Tretinoin