Severe Multiorgan Failure Associated with Differentiation Syndrome in a High-risk Acute Promyelocytic Leukemia Patient with Concurrent Influenza A
Year: 2026
Type: article
Study design: Case Report
Abstract: Differentiation syndrome (DS) is rarely observed before treatment in patients with acute promyelocytic leukemia (APL). A 35-year-old man with high-risk APL and influenza A presented with multiple organ failure (MOF). Initially attributed to influenza, the DS-like symptoms rapidly worsened after the initiation of all-trans retinoic acid. Despite intensive care and continuous hemodialysis, the patient developed a cerebral hemorrhage. Consequently, dose-adjusted arsenic trioxide (ATO; 0.1 mg/kg/day) was administered. He achieved complete remission (CR) on day 28 and maintained molecular CR for 16 months without sequelae. Concurrent infections can mask DS-like symptoms prior to treatment. Reduced-dose ATO is an effective salvage option for patients with APL and severe MOF.
Source: Internal Medicine
Institution: Toyohashi Municipal Hospital
Language: English
Subfield: Molecular Biology
Domain: Life Sciences
Open Access status: diamond
OpenAlex ID: W7204078017