Advertisement

Clinical Toxicology of the Retinoids

  • Raymond P. WarrellJr
  • Ugo Pastorino
  • Andrea Decensi
Conference paper
Part of the ESO Monographs book series (ESO MONOGRAPHS)

Abstract

As a class, the retinoids have many side-effects in common. A list of the most frequently observed reactions in relation to the organ systems affected is given in Table 1. Compared to most other drugs used for cancer chemotherapy, these reactions are relatively mild; however, serious and occasionally fatal reactions have occurred, particularly in patients with acute promyelocytic leukaemia (APL).

Keywords

Retinoic Acid Acute Promyelocytic Leukaemia Clinical Toxicology Acute Promyelocytic Leukaemia Patient Synthetic Retinoid 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Warrell RP Jr, de Thé H, Wang Z-Y, Degos L: Acute promyelocyte leukemia. N Engl J Med 1993 (329): 177–189PubMedCrossRefGoogle Scholar
  2. 2.
    Lee JS, Newman RA, Lippman SM et al: Phase I evaluation of all-trans retinoic acid in adults with solid tumors. J Clin Oncol 1993 (11):959PubMedGoogle Scholar
  3. 3.
    Smith MA, Adamson PC, Balis FM et al: Phase I and pharmacokinetic evaluation of all-trans retinoic acid in pediatric patients with cancer. J Clin Oncol 1992 (10):1666–1673PubMedGoogle Scholar
  4. 4.
    Frankel SR, Eardley A, Heller G, Berman E, Warrell RP Jr: All-trans retinoic acid for acute promyelocyte leukemia: results of the New York study. Ann Intern Med 1994 (120):278–286PubMedGoogle Scholar
  5. 5.
    DiGiovanna J, Helfgott R, Gerber L et al: Extraspinal tendon and ligament calcification associated with long-term therapy with etretinate. N Engl J Med 1986 (315):1177–1182PubMedCrossRefGoogle Scholar
  6. 6.
    Kilcoyne R: Effects of retinoids on bone. J Am Acad Dermatol 1988 (19):212–216PubMedCrossRefGoogle Scholar
  7. 7.
    Akiyama H, Nakamura N, Nagasaka S, Sakamaki H, Onozawa Y: Hypercalcaemia due to all-trans retinoic acid. Lancet 1992 (339):308–309PubMedCrossRefGoogle Scholar
  8. 8.
    Niesvizky R, Siegel D, Straus D et al: Hypercalcemia and increased serum interleukin-6 (IL-6) levels induced by all-trans retinoic acid (ATRA) in patients with multiple myeloma. Proc Am Soc Clin Oncol 1993 (12):407Google Scholar
  9. 9.
    Warrell RP Jr, Frankel SR, Miller WH Jr et al: Differentiation therapy of acute promyelocytic leukemia with tretinoin (all-trans retinoic acid). N Engl J Med 1991 (324): 1385–1393PubMedCrossRefGoogle Scholar
  10. 10.
    Izumi T, Hatake K, Miura Y: Acute promyelocytic leukemia (letter). New Engl J Med 1994 (330): 141PubMedCrossRefGoogle Scholar
  11. 11.
    Runde V, Aul C, Sudhoft T, Heyll A, Schneider W: Retinoic acid in the treatment of acute promyelocytic leukemia: Inefficacy of the 13-cis isomer and induction of complete remission by the all-trans isomer complicated by thromboembolic events. Ann Hematol 1992 (64):270–272PubMedCrossRefGoogle Scholar
  12. 12.
    Koike T, Tatewaki W, Aoki A et al: Severe symptoms of hyperhistaminemia after the treatment of acute promyelocytic leukemia with tretinoin (all-trans retinoic acid). New Engl J Med 1992 (327): 385–387PubMedCrossRefGoogle Scholar
  13. 13.
    Lammer EJ, Chen DT, Hoar RM et al: Retinoic acid fetopathy. N Engl J Med 1985 (313):837–841PubMedCrossRefGoogle Scholar
  14. 14.
    Dai WS, LaBraico JM, Stern RS: Epidemiology of isotretinoin exposure during pregnancy. J Am Acad Dermatol 1992 (26):599–560PubMedCrossRefGoogle Scholar
  15. 15.
    Jick SS, Terris BZ, Jick H: First trimester topical tretinoin and congenital disorders. Lancet 1993 (341):1181–1182PubMedCrossRefGoogle Scholar
  16. 16.
    Frankel SR, Eardley A, Lauwers G, Weiss M, Warrell RP Jr: The “retinoic acid syndrome” in acute promyelocytic leukemia. Ann Intern Med 1992 (117):292–296PubMedGoogle Scholar
  17. 17.
    Vadhat L, Eardley A, Heller G, Warrell RP Jr: Leukocytosis, the retinoic acid syndrome, and early mortality in acute promyelocytic leukema: when is chemotherapy needed during remission induction with all-trans retinoic acid. Blood 1993 (82 suppl):192AGoogle Scholar
  18. 18.
    Castaigne S, Chomienne C, Fenaux P, Daniel MT, Degos L: Hyperleukocytosis during all-trans retinoic acid for acute promyelocytic leukemia. Blood 1990 (76 suppl):260aGoogle Scholar
  19. 19.
    Fenaux P, Le Dely MC, Castaigne S et al: Effect of all-trans retinoic acid in newly diagnosed acute promyelocytic leukemia: results of a multicenter randomized trial. Blood 1993 (82):3241–3249PubMedGoogle Scholar
  20. 20.
    Eardley AM, Heller G, Warrell RP Jr: Morbidity and costs of all-trans retinoic acid compared to standard chemotherapy for remission induction in acute promyelocytic leukemia. Leukemia 1994 (8):934–939PubMedGoogle Scholar
  21. 21.
    Dombret H, Sutton L, Duarte M, Daniel MT, Leblond V, Castaigne S et al: Combined therapy with all-trans retinoic acid and high-dose chemotherapy in patients with hyperleukocytic acute promyelocytic leukemia and severe visceral hemorrhage. Leukemia 1992 (6):1237–1242PubMedGoogle Scholar
  22. 22.
    Costa A, Malone W, Perloff M et al: Tolerability of the synthetic retinoid fenretinide (HPR). Eur J Cancer Clin Oncol 1989 (25):805–808PubMedCrossRefGoogle Scholar
  23. 23.
    Rotmensz N, De Palo G, Formelli F et al: Long term tolerability of fenretinide (4-HPR) in breast cancer patients. Eur J Cancer 1991 (2):1127–1131Google Scholar
  24. 24.
    Pizzichetta M, Rossi R, Costa A et al: Lipoproteins in fenretinide (4-HPR) treated patients. Diab Nutr Metab 1992 (5):71–72Google Scholar
  25. 25.
    Decensi A, Torrisi R, Polizzi A et al: Effect of the synthetic retinoid fenretinide on dark-adaptation and the ocular surface. JNCI 1994 (86): 105–110PubMedGoogle Scholar
  26. 26.
    Torrisi R, Parodi S, Fontana V et al: Factors affecting plasma retinol decline during long-term administration of the synthetic retinoid Fenretinide in breast cancer patients. Cancer Epidemiol Biomarkers & Prev 1994 (3):507–510Google Scholar
  27. 27.
    Gross EG and Helfgott MA: Retinoids and the eye. Dermatol Clin 1992 (10):521–531PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1995

Authors and Affiliations

  • Raymond P. WarrellJr
    • 1
  • Ugo Pastorino
    • 2
  • Andrea Decensi
    • 3
  1. 1.Department of MedicineMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  2. 2.Department of Thoracic SurgeryIstituto Nazionale TumoriMilanItaly
  3. 3.Department of Medical Oncology IIIstituto Nazionale per la Ricerca sul CancroGenoaItaly

Personalised recommendations