GPY Tong, JKH Chiu, CW Luk, SY Ha

Abstract

Oral all-trans retinoic acid (ATRA) is an integral part of acute promyelocytic leukaemia (APL) treatment. However, it poses difficulties for patients who cannot tolerate oral medication. We report a child with APL which was complicated by ruptured acute appendicitis and paralytic ileus. As a result, oral ATRA was administered sublingually during induction. Clinical remission was achieved after induction and the patient went on with subsequent chemotherapy with no relapse for more than 3 years from diagnosis. We reviewed the literature about the necessity of ATRA in APL treatment and how sublingual ATRA was used.