RETIN - a
For ingestion: induction of remission in acute promyelocytic leukemia characterized by translocation t(15; 17) and / or the presence of the chimeric gene PML/RAR-alpha, in patients previously untreated, including relapses after chemotherapy with the inclusion of anthracyclines or refractory to standard chemotherapy schemes.
For local use: plum eels, vulgar eels, including with the formation of comedones, papules, pustules, Favra-Rakusho disease (cystic nodal skin elastosis with comedones), hyperpigmentation.
Hypersensitivity, for local application - acute inflammatory (including eczematous) skin lesions (dermatitis, seborrhea, etc.), rosacea, wounds, skin burns, photosensitization, rectal diseases.
Restrictions on use
Lack of reliable contraception in women of childbearing age, intracranial hypertension (especially in children), hypercholesterolemia, hypertriglyceridemia, leukocytosis (more than 5-109/l), liver and kidney dysfunction, pancreatitis, diabetes mellitus, chronic intoxication (in tel.alcoholic), age over 50 years, children's age (up to 1 year if prescribed intravenously and up to 12 years if used locally).
Application during pregnancy and breastfeeding
It's contraindicated for pregnancy. Prescription of retinoids to pregnant women leads to termination of pregnancy and violation of fetal formation (violation of formation and development of structures of the CNS, eyes, thymus, muscular system, etc.). Breastfeeding should be stopped for the duration of treatment.
Side effects of the substance Tretinoin. From the cardiovascular system and blood (hematopoiesis, hemostasis): arrhythmia (23%), arterial hypotension (14%), hypertension (11%), phlebitis (11%), heart failure (6%), in 3% of cases - myocardial infarction, myocarditis, pericarditis, pulmonary hypertension, cardiomyopathy; Violation of blood clotting (phlebitis, ICE syndrome, C/Hemorrhage), peripheral edema, ascites, basophilia, hyperhistaminesmia, hypercalcemia.
Tretinoin dosage and symptoms: "retinoic acid syndrome."
Treatment: conduct a course of treatment with dexamethasone (10 mg every 12 hours for 3 days).
Ways of administration
Precautions for the Tretinoin substance.
In the case of inpatient treatment, it is carried out under the careful supervision of an oncologist or hematologist. Before treatment of leukemia it is necessary to perform cytogenetic examination to detect changes in chromosomes (in the absence of chromosome t(15; 17) translation and/or the corresponding transcript of PML/RAR-alpha). During treatment, cholesterol levels, triglycerides, leukocyte counts and liver function should be monitored. Adequate measures and facilities should be provided to diagnose and treat possible complications. Acute leukemia relapse is possible after 2-4 weeks after treatment termination. Women (even with anamnestic indications of infertility) should use adequate contraceptive measures a month before, during and within a month after the course.