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. 2024 Jul 15;14(1):113.
doi: 10.1038/s41408-024-01074-y.

Improved prevention and treatment strategies for differentiation syndrome contribute to reducing early mortality in patients with acute promyelocytic leukemia

Qian Wu #  1   2 , Xiaofei Yang #  1   2 , Jingren Zhang  1   2 , Mengxing Xue  1   2 , Xueqing Dou  1   2 , Zheng Ge  3 , Yifei Chen  4 , Weiying Gu  5 , Weimin Dong  5 , Hongying Cao  6 , Naike Jiang  6 , Xuemei Sun  7 , Zefa Liu  8 , Jinning Shi  9 , Hui Chen  10 , Cixian Zhang  11 , Fengling Min  12 , Hongli Sun  13 , Xiaoli Qian  14 , Hongjian Yuan  14 , Yuan Feng  15 , De-Pei Wu  16   17 , Suning Chen  18   19
Affiliations

Improved prevention and treatment strategies for differentiation syndrome contribute to reducing early mortality in patients with acute promyelocytic leukemia

Qian Wu et al. Blood Cancer J. .
No abstract available

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Prophylaxis and management for APL DS.
A Prophylaxis against APL DS. B Management for APL DS. aIf the WBC count exceeded 10 × 109/L, 4-6 doses of IDA (2-5 mg/dose) were administrated 72 hours after initiation of ATRA in case of fatal bleeding risk. bAdministrated DXMS 10 mg twice daily promptly at the earliest symptom or sign suggestive of DS, such as dyspnea, unexplained fever, weight gain greater than 5 kg, unexplained hypotension, acute renal failure, pulmonary infiltrates, or pleuropericardial effusion. cPatients should be closely monitored. If the symptoms/signs did not improve within 24 hours or worsened in 8 hours (e.g., shortness of breath, slight hemoptysis, lower blood oxygen saturation, high-flow oxygen therapy requirement, and progressive oliguria), ruxolitinib should be initiated. dThe selection of different doses of ruxolitinib should be based on a comprehensive evaluation of the severity of DS, age, weight, general condition, and accompanying comorbidities. eThe details of aggressive supportive care are available in the Supplementary Appendix. WBC white blood cell, ATRA all-trans retinoic acid, HU hydroxyurea, DXMS dexamethasone, IDA idarubicin, DS differentiation syndrome.
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