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APL Differentiation Syndrome

Imaging findings

CT in an acute promyelocytic leukemia (APL) patient shows diffuse, extensive crazy-paving ground-glass opacities and consolidations with pleural effusions two days after starting ATRA and arsenic trioxide therapy, representing differentiation syndrome.

Key takeaways

Differentiation syndrome (formerly ATRA syndrome) is a life-threatening complication of APL therapy. It is characterized by cytokine release causing increased capillary permeability and pulmonary edema. Prompt treatment with high-dose steroids is mandatory.

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