Park Jeong A, Yun Jong Hyung, Kang Hyoung Jin, Shin Hee Young, Ahn Hyo Seop
Department of Pediatrics and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Pediatr Blood Cancer. 2008 Apr;50(4):872-4. doi: 10.1002/pbc.21302.
Arsenic trioxide (As(2)O(3)) is an effective agent for the treatment of relapsed acute promyelocytic leukemia (APL). We report a patient with intestinal pseudo-obstruction, which occurred while treating relapsed APL with As(2)O(3). A 6-year-old female with relapsed APL developed paralytic ileus, hyperleukocytosis, and a high fever while being treated with As(2)O(3). Although As(2)O(3) was discontinued and dexamethasone was administered, vomiting and abdominal distension worsened. An ileostomy was performed and diffuse patch-like infiltrations on the bowel surface were noted. Pathologic findings revealed APL cells involving the entire intestinal layers. This case history suggests that As(2)O(3) when used for reinduction therapy for APL may adversely affect the intestine and cause acute intestinal pseudo-obstruction.
三氧化二砷（As₂O₃）是治疗复发急性早幼粒细胞白血病（APL）的有效药物。我们报告了1例在用As₂O₃治疗复发APL时发生肠道假性梗阻的患者。1例复发APL的6岁女性在接受As₂O₃治疗时出现麻痹性肠梗阻、白细胞增多症和高热。尽管停用了As₂O₃并给予了地塞米松，但呕吐和腹胀仍加重。进行了回肠造口术，发现肠表面有弥漫性片状浸润。病理结果显示APL细胞累及整个肠层。该病例提示，As₂O₃用于APL再诱导治疗时可能对肠道产生不良影响并导致急性肠道假性梗阻。
