High Pseudotumor Cerebri Incidence in Tretinoin and Arsenic Treated Acute Promyelocytic Leukemia and the Role of Topiramate After Acetazolamide Failure

Overview

Journal Leuk Res Rep

Date 2014 Sep 3

PMID 25180154

Citations 5

Authors

Morgan B Smith

Elizabeth A Griffiths

James E Thompson

Eunice S Wang

Meir Wetzler

Craig W Freyer

Affiliations

Soon will be listed here.

Abstract

Dual differentiation therapy with arsenic trioxide and tretinoin (all-trans-retinoic acid; ATRA) for the management of low and intermediate risk acute promyelocytic leukemia has recently been recommended by the National Comprehensive Cancer Network. Some less common toxicities of the combination may have yet to be fully realized. Of ten patients we have treated thus far, five (50%) have developed pseudotumor cerebri. In one patient, temporary discontinuation of ATRA and initiation of acetazolamide controlled symptoms. In four patients, topiramate was substituted for acetazolamide to relieve symptoms and allow ATRA dose re-escalation. We conclude that providers should monitor for pseudotumor cerebri and consider topiramate if acetazolamide fails.

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