A 70 year old male presented with excessive fatigue, fever & bleeding from gums while brushing. O/E- he has splenomegaly. CBC shows marked pancytopenia with presence of blasts. t(15;17)(q22;q12) cytogenetic rearrangement is found in this patient. Which of the following agents will you use in management of this patient?
Correct Answer: Tretinoin
Description: Given scenario suggests the diagnosis of Acute promyelocytic leukemia (APML) ATRA (all trans retinoic acid) is used in management of APML. Induces the differentiation of leukemic cells bearing translocation , where disruption of the RARA gene encoding a retinoid acid receptor occurs. Decreases the frequency of DIC S/E: APL differentiation syndrome- Occurring within the first 3 weeks of treatment, characterized by fever, dyspnea, chest pain, pleural and pericardial effusions, and hypoxemia Rx: Glucocoicoids, chemotherapy, and/or suppoive measures =Cytarabine and daunorubicin increases risk of disseminated intravascular coagulation (DIC) =Rituximab is a monoclonal antibody against CD20 used in autoimmune and malignant diseases
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