Hematology Department, Aziza Othmana University Hospital, Tunis, Tunisia.
Med Oncol. 2011 Mar;28(1):279-81. doi: 10.1007/s12032-010-9462-y. Epub 2010 Mar 5.
Differentiation syndrome (DS) is a life-threatening complication observed in patients with acute promyelocytic leukemia (APL) receiving induction therapy with all-trans-retinoic acid (ATRA). A bimodal incidence of DS has been observed, with a majority of cases occurring during the first week of ATRA treatment ("early" DS), but a substantial number of cases occurring during the third or even fourth week of ATRA treatment ("late" DS). However, to our knowledge occurrence of both early and late DS in the same patient has not been reported. We report an APL patient treated with the AIDA regimen, who experienced both early and late DS, a situation where differential diagnosis was difficult.
分化综合征（DS）是接受全反式维甲酸（ATRA）诱导治疗的急性早幼粒细胞白血病（APL）患者中观察到的一种危及生命的并发症。DS 的发生率呈双峰模式，大多数病例发生在 ATRA 治疗的第一周（“早期”DS），但相当数量的病例发生在 ATRA 治疗的第三周甚至第四周（“晚期”DS）。然而，据我们所知，同一患者同时发生早期和晚期 DS 的情况尚未报道。我们报告了一例接受 AIDA 方案治疗的 APL 患者，该患者同时出现了早期和晚期 DS，这种情况鉴别诊断较为困难。
