Retinoic acid syndrome is the major adverse effect of tretinoin and it occurs in
about 25% of treated APL patients in the absence of prophylactic measures
and is often fatal. Generally, the retinoic acid syndrome is associated with
increasing leucocyte counts and is probably caused by the release of several
cytokines by maturing blast cells. The retinoic acid syndrome gives a clinical
picture of bodyweight gain, respiratory distress, serous effusions and cardiac
and renal failure.
