Síndrome de diferenciación en paciente con leucemia promielocítica aguda: importancia de la TC de tórax

Sarasúa, Luis Gorospe; Ventura-Díaz, Sofía; Ayala-Carbonero, Ana María; Gambí-Pisonero, Esther; Cruz, Adrián Sánchez-Tornero de la; Pérez-Lamas, Lucía; Mirambeaux-Villanova, Rosa Mariela; Chinea-Rodríguez, Anabelle

doi:10.1016/j.arbres.2019.11.004

Cited by 1 publication

(2 citation statements)

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“…Increased cardiothoracic ratio, increased vascular pedicle, pleural effusions, consolidations, and interstitial edema are common findings seen in chest radiographs in patients that develop DS [48][49][50][51]. Chest computed tomography (Chest CT) may be useful to further evaluate the lung parenchyma and to evaluate for the presence of pericardial effusions [47,48]. Davis et al described the chest CT findings of patients diagnosed with DS and showed that small, peripheral nodules, pleural effusions, and ground-glass opacities were the most consistent chest CT findings [51].…”

Section: The Role Of Imagingmentioning

confidence: 98%

“…Pulmonary findings on chest radiographs are seen in up to 38% of patients with moderate DS and 80% in patients with severe DS [33]. Increased cardiothoracic ratio, increased vascular pedicle, pleural effusions, consolidations, and interstitial edema are common findings seen in chest radiographs in patients that develop DS [48][49][50][51]. Chest computed tomography (Chest CT) may be useful to further evaluate the lung parenchyma and to evaluate for the presence of pericardial effusions [47,48].…”

Section: The Role Of Imagingmentioning

confidence: 99%

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Differentiation Syndrome in Acute Leukemia: APL and Beyond

Woods,

Norsworthy

2023

Cancers

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Differentiation syndrome (DS) is a frequent and potentially life-threatening clinical syndrome first recognized with the advent of targeted therapeutics for acute promyelocytic leukemia (APL). DS was subsequently observed more broadly with targeted therapeutics for acute myeloid leukemia (AML). DS is typically characterized by fever, dyspnea, hypotension, weight gain, pleural or pericardial effusions, and acute renal failure. The incidence in patients with APL ranges from 2 to 37%, with the wide variation likely attributed to different diagnostic criteria, use of prophylactic treatment, and different treatment regimens. Treatment with corticosteroids +/- cytoreductive therapy should commence as soon as DS is suspected to reduce DS-related morbidity and mortality. The targeted anti-leukemic therapy should be discontinued in patients with severe DS. Here, we discuss the pathogenesis of DS, clinical presentations, diagnostic criteria, management strategies, and implementation of prospective tracking on clinical trials.

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