tretinoin and Venous-Thrombosis

Bleeding is a common complication during initial induction treatment for acute promyelocytic leukemia (APL). Administration of all-trans-retinoic acid (ATRA), which is in routine use for APL in the past decade improves the bleeding tendency dramatically. Nevertheless, thrombotic events have still been reported in a small proportion of APL patients treated with ATRA. Here we describe a case of splenic infarction and life threatening thrombosis in a young patient with APL treated with ATRA. We review the relevant literature and discuss the pathophysiology, risk factors and treatment of this complication occurring during therapy, for APL.

Topics: Adult; Anticoagulants; Humans; Leukemia, Promyelocytic, Acute; Male; Pulmonary Embolism; Remission Induction; Splenic Infarction; Syndrome; Thrombophilia; Tretinoin; Venous Thrombosis

Thrombosis is a leading cause of morbidity and mortality. Fibrinogen, the soluble substrate for fibrin-based clotting, has a central role in haemostasis and thrombosis and its plasma concentration correlates with cardiovascular disease event risk and a prothrombotic state in experimental models. We aimed to identify chemical entities capable of changing fibrinogen production and test their impact on experimental thrombosis. A total of 1,280 bioactive compounds were screened for their ability to alter fibrinogen production by hepatocyte-derived cancer cells and a selected panel was tested in zebrafish larvae. Anthralin and all-

Topics: Animals; Animals, Genetically Modified; Anthralin; Blood Coagulation; Disease Models, Animal; Fibrinogen; Fibrinolytic Agents; Hep G2 Cells; Hepatocytes; Humans; Integrin alpha2; Morpholinos; Mutation; Oligonucleotides, Antisense; Proteomics; Small Molecule Libraries; Tretinoin; Venous Thrombosis; Zebrafish; Zebrafish Proteins

Topics: Adolescent; Child; Child, Preschool; China; Female; Humans; Leukemia, Promyelocytic, Acute; Male; Thrombosis; Tretinoin; Venous Thrombosis

A 33-year-old man of a Middle Eastern origin presented to us with abdominal pain and distension secondary to refractory ascites of 1-month duration. The patient had a history of taking oral retinoic acid 25 mg for 4 months for mycosis fungoides. Investigations revealed thrombosis of hepatic veins with extensive thrombosis of the porto-mesenteric axis. A combination of transjugular intrahepatic portosystemic shunt, balloon angioplasty and thrombolysis with recombinant tissue plasminogen activator was successfully used to treat his condition.

Topics: Abdominal Pain; Adult; Angioplasty, Balloon; Antineoplastic Agents; Ascites; Humans; Male; Mycosis Fungoides; Portasystemic Shunt, Transjugular Intrahepatic; Splanchnic Circulation; Stents; Tissue Plasminogen Activator; Treatment Outcome; Tretinoin; Venous Thrombosis