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?
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
Acyclovir
Daunorubicin
Rituximab
Tretinoin
AML & ALL