4. A 43-year-old woman is receiving induction therapy with daunorubicin and all-trans-retinoic acid (ATRA) for acute promyelocytic leukemia. Eleven days after starting treatment she develops dyspnoea, fever, peripheral oedema and bilateral pleural effusions. Arterial oxygen saturation is found to be reduced. The specific management of this condition includes?
1. Blood cultures followed by broad spectrum antibiotics
2. Stop ATRA and no further readministration of ATRA
3. Leukapheresis
4. Stop ATRA and give corticosteroids
Answer = [4] The condition describes differentiation syndrome which is seen during APML treatment by ATRA and correct management includes stopping ATRA and to give corticosteroids.