2015 Antineoplastics

DIFFERENTIATING AGENTS

TRETINOIN (all-trans retinoic acid; ATRA)

  • in APL, activates the differentiation program (converting promyelocytes into granulocytes) and promotes degradation of the PML-RAR fusion protein

  • doesn't kill cells itself; requires cytotoxic agent like ARSENIC TRIOXIDE or anthracycline antibiotic
  • also used to treat acne (gel form)

  • toxicities include:
    • headache, dry skin, reversible hepatic enzyme abnormalities, bone tenderness, hyperlipidemia
    • CNS toxicity: dizziness, anxiety, depression, confusion, agitation
    • DIFFERENTIATION SYNDROME (formerly called retinonic acid syndrome): fever, dyspnea, weight gain, pulmonary infiltrates
      • with or without pleural or pericardial effusions
      • with or without leucocytosis
      • can be fatal

    • birth defects (teratogenic)
Email: Dr. Janet Fitzakerley | ©2015 University of Minnesota Medical School Duluth | Last modified: 10-may-15 8:55 PM