Pregnancy-induced hypertension caused by all-trans retinoic acid treatment in acute promyelocytic leukemia

Song, Kyo D.; Li, Min

doi:10.3892/ol.2015.3190

Cited by 3 publications

(1 citation statement)

References 12 publications

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“…PIH women are hypercoagulable to further induce fetal hypoxia caused by vascular occlusion [12,19]. Synthesized and secreted maternity thyroid hormones shall not only meet their own metabolic demands but also the metabolic demands of fetal central nervous system and placenta.…”

Section: Discussionmentioning

confidence: 99%

The specificity of color Doppler ultrasound to detect fetal hypoxia in pregnancy-induced-hypertension with thyroid dysfunction

Xiao¹,

Yin²,

Wang³

et al. 2018

biomedicalresearch

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The incidence of fetal hypoxia in pregnant women with Pregnancy-Induced Hypertension (PIH) is higher than normal pregnant women. Thyroid hormone is closely related to organism's metabolism. In this study, Color Doppler ultrasound was used to diagnose fetal hypoxia in pregnant women with PIH to further explore the correlation of hemodynamic indexes and thyroid hormone levels. 70 cases of pregnant women with PIH were divided into thyroid-normal group (39 cases), hyperthyroidism group (12 cases) and hypothyroidism group (19 cases). The hemodynamic indexes of Middle Cerebral Artery (MCA) and Umbilical Artery (UA) were detected by color Doppler ultrasound. In hyperthyroidism and hypothyroidism groups, the hemodynamic indexes of MCA were lower and hemodynamic indexes of UA were higher than thyroid-normal group. The results of correlation tests showed that, the hemodynamic indexes of UA and fetal hypoxia were both significantly correlated to thyroid hormone levels respectively, in pregnant women with PIH. Therefore, the hemodynamic index of UA may be an index which can predict thyroid function status in pregnant women with PIH. Pregnant women with PIH and thyroid dysfunction are more likely to get fetal hypoxia than those with normal thyroid function. Color Doppler ultrasound is sensitive to detect the changes.

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Section: Discussionmentioning

confidence: 99%

The specificity of color Doppler ultrasound to detect fetal hypoxia in pregnancy-induced-hypertension with thyroid dysfunction

Xiao¹,

Yin²,

Wang³

et al. 2018

biomedicalresearch

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Tretinoin

2015

Reactions Weekly

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A 23-year-old pregnant woman developed pregnancyinduced hypertension during treatment with tretinoin for acute promyelocytic leukaemia (APL).The woman was diagnosed with APL during the sixth month of pregnancy and began receiving tretinoin [all-trans retinoic acid; ATRA] 45 mg/m 2 /day [route not stated] at 26 weeks of gestation. On therapy day 3, she reported chest distress and polypnoea; a physical examination revealed generalised oedema, a BP of 149/103mm Hg and a HR of 110bpm. On day 6, laboratory investigations identified the following: pancytopenia, albumin 28 g/L, blood creatinine 246 µmol/L and urine protein ++. Pregnancy-induced hypertension syndrome was diagnosed.Fetal demise was identified on day 8 and the pregnancy was terminated by caesarean section. The woman's BP and HR subsequently normalised. Her tretinoin dosage was decreased to 25 mg/m 2 /day on day 14, and she ultimately achieved complete remission.Author comment: "ATRA treatment may have initiated or aggravated the pregnancy‑induced hypertension during the administration process. Therefore, it was concluded that the pregnancy‑induced hypertension in the present study resulted from ATRA treatment." Song K, et al. Pregnancy-induced hypertension caused by all-trans retinoic acid treatment in acute promyelocytic leukemia: A case report. Oncology Letters 10: 364-366, No. 1, Jul 2015 -China 803126475 » Editorial comment: A search of AdisBase, Medline andEmbase did not reveal any previous case reports of pregnancyinduced hypertension associated with tretinoin.The WHO ADR database contained no reports of gestational hypertension associated with tretinoin.

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Acute Promyelocytic Leukemia during Pregnancy: A Systematic Review of the Literature

Santolaria

Perales

Montesinos

et al. 2020

Cancers

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The management of pregnant women with acute promyelocytic leukemia (APL) is a challenging situation where limited evidence-based information is available. We performed a systematic literature review to analyze the outcomes reported for both mother and fetus when APL is diagnosed during pregnancy. PubMed, Scopus and Web of Science databases were systematically searched to identify studies reporting cases of APL during pregnancy. Sixty-six articles met the eligibility criteria (53 single case reports). Ninety-two patients were eligible for induction therapy, with most them being treated with all-trans retinoic acid alone (32%) or combined with chemotherapy (43%), while the remaining patients received chemotherapy alone. Three patients were treated with arsenic-based regimens after delivery. Overall complete remission rate was 89%, with no statistically significant differences according to the type of induction and gestational age. During the first trimester, women were more likely to experience spontaneous and induced abortion compared to those during the second trimester (88% vs. 30%) (p < 0.0001), while only one patient diagnosed during the third trimester terminated in stillbirth. Twelve of 16 infants with neonatal complications had respiratory distress syndrome. Except two early deaths (Potter’s syndrome and pulmonary hemorrhage), all neonates evolved favorably. This study confirms that gestational age does not affect the results in the mother, but is closely related to fetal viability. Our results may be useful for the process of decision making that requires the involvement of the patient, hematologist, obstetrician and neonatologist.

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Pregnancy-induced hypertension caused by all-trans retinoic acid treatment in acute promyelocytic leukemia

Cited by 3 publications

References 12 publications

The specificity of color Doppler ultrasound to detect fetal hypoxia in pregnancy-induced-hypertension with thyroid dysfunction

The specificity of color Doppler ultrasound to detect fetal hypoxia in pregnancy-induced-hypertension with thyroid dysfunction

Tretinoin

Acute Promyelocytic Leukemia during Pregnancy: A Systematic Review of the Literature

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