Successful Outcome of Acute Promyelocytic Leukemia Complicated by Bone Marrow Necrosis and Posterior Reversible Encephalopathy Syndrome, During Treatment With an All-Trans Retinoic Acid Plus Arsenic Trioxide-Based Regimen.

Acute promyelocytic leukemia (APL) is a distinct subtype of acute myeloid leukemia characterized by the PML-RARA fusion gene and frequent coagulopathy. All-trans retinoic acid (ATRA) plus arsenic trioxide (ATO)-based regimens achieve excellent complete remission rates exceeding 95% with durable molecular responses. However, treatment-related and disease-related complications may occur during therapy. We report a case of a 57-year-old man with APL complicated by bone marrow necrosis, pulmonary complications, and posterior reversible encephalopathy syndrome. Multidisciplinary supportive care with continuation of ATRA-ATO therapy resulted in complete hematologic and molecular remission. This case highlights the importance of recognizing and managing complex complications in APL while maintaining curative therapy.