A patient on treatment for leukemia, develops chest pain, pulmonary infiltrates and pleural effusion. The likely cause is:
TRETINOIN: It is an all trans retinoic acid,a form of Vit A acid which acts as a differentiating agent and has recently emerged as a highly effective treatment for APL(Acute Promyelocytic Leukemia). Adverse Effects >10% Headache (86%) Fever (83%) Bone pain (77%) Dry mucous membranes (77%) Malaise (67%) URI (63%) Shivering (60%) Dyspnea (60%) Hemorrhage (60%) Elevated liver function tests (50-60%) Hyperlipidemia (60%) Infections (58%) Nausea and vomiting (57%) Rash (54%) Peripheral edema (52%) Leukocytosis (40%) Pain (37%) Abdominal pain (31%) DIC (26%) Respiratory insufficiency (26%) Mucositis (26%) GI disorder (26%) Retinoic acid-APL syndrome (25%) Ear ache (23%) Diarrhea (23%) Pleural effusion (20%) Dizziness (20%) Pruritus (20%) Sweating (20%) Anxiety (17%) Paresthesia (17%) Constipation (17%) Vision changes (17%) Dyspepsia (14%) Rales (14%) Depression (14%) Insomnia (14%) Alopecia (14%) Skin changes (14%) Confusion (11%) Abdominal distention (11%) Renal insufficiency (11%) 1-10% (selected): Cardiac failure Pseudotumor cerebri Ulcer. REFERENCE: ESSENTIALS OF MEDICAL PHARMACOLOGY , refence.medscape.com ( K.D.TRIPATHI SEVENTH EDITION PAGE NO:869)
Daunorubicin
Hydroxyurea
Cytarabine
Tretinoin
Chemotherapy