Tretinoin is a retinoid that is a form of vitamin A used to treat acute myeloid leukemia. The Food and Drug Administration (FDA) has already approved this medication. Tretinoin helps lessen the signs and severity of this disease and promotes the growth of normal and mature cells in the blood and bone marrow. This medication helps to reverse symptoms of the disease as well.

Acute myeloid leukemia is a cancer of the blood and bone marrow which is the spongy tissue inside bones where blood cells are made. General signs and symptoms of the early stages of this disease may copy those of the flu. Signs and symptoms may vary based on the type of blood cell affected. Signs and symptoms of acute myeloid leukemia include:

  • Bone pain
  • Fever
  • Shortness of breath
  • Fatigue
  • Pale skin
  • Easy bruising
  • Frequent infections
  • Unusual bleeding such as frequent nosebleeds and bleeding from the gums

Acute myeloid leukemia is caused by damage to the DNA of developing cells in your bone marrow. When this occurs, blood cell production goes wrong. The bone marrow creates immature cells that develop into leukemic white blood cells called myeloblasts. These abnormal cells are unable to function properly. They may also build up and crowd out healthy cells. Radiation and exposure to certain chemicals and some chemotherapy drugs are known risk factors for acute myelogenous leukemia. Cancer starts when cells in a part of the body begin to grow out of control. There are many kinds of cancer. Cells in nearly any part of the body can become cancer.

Factors that may increase your risk of acute myeloid leukemia include:

  • Smoking. This condition is linked to cigarette smoke which contains benzene and other known cancer-causing chemicals.
  • Your sex. Men are more likely to develop this type of condition than are women.
  • Increasing age. The risk of acute myeloid leukemia increases with age. This is most common in adults age 65 and older.
  • Previous cancer treatment. People who’ve had certain types of chemotherapy and radiation therapy may have a greater risk of developing acute myeloid leukemia.
  • Dangerous chemical exposure. Exposure to certain chemicals such as benzene is linked to a greater risk of acute myeloid leukemia.
  • Exposure to radiation. People exposed to very high levels of radiation such as survivors of a nuclear reactor accident or have an increased risk of developing acute myeloid leukemia.

How does Tretinoin work?

In leukemia, the bone marrow produces too many immature white blood cells. These abnormal cells take up space in the bone marrow and result in less room for the production of normal healthy blood cells.
The way tretinoin works is thought to stop the abnormal blood cells from increasing in numbers. It also stimulates the abnormal promyelocytic cells to mature and develop normally which allow space for the growth of normal and mature blood cells in the bone marrow and blood. Tretinoin is used to induce remission in this particular type of leukemia. It is not a chemotherapy medicine itself.

How to use Tretinoin?

Use this medication regularly in order to get the most benefit from it. Remember to use it at the same time and in the same way each day. The dosage is based on your medical condition, body size, and response to therapy. Follow the directions of your doctor for how long to take this medication. Do not increase your dose or take this medication more often without your doctor’s approval. Your condition will not improve any faster and the risk of serious side effects may be increased.
Take this medication by mouth usually twice a day or as directed by your doctor. It may be taken with food. Drink plenty of fluids while having this treatment. If you missed a dose, call your doctor at once. Do not double the dose to make up for the missed one. Inform your doctor if your condition does not improve or if it gets worse.

What are the side effects of Tretinoin?

Common side effects:

  • Vomiting
  • Fever
  • Weakness
  • Nausea
  • Tiredness
  • Bine pain
  • Itching, rash, or dry skin
  • Increased sweating
  • Hair loss or skin changes
  • Headache
  • Dry mouth, nose, or throat
  • Vision changes

Call your doctor right away if you have the following:

  • A light-headed feeling like you might pass out
  • Mouth and throat ulcers
  • Red or swollen gums
  • Burning mouth pain
  • Trouble swallowing
  • Increased pressure inside the skull (ringing in your ears, severe headaches, vision problems, dizziness, or pain behind your eyes)
  • Liver problems (jaundice, upper stomach pain, dark urine, loss of appetite, clay-coloured stools)
  • Kidney problems (swelling in your feet or ankles, little or no urinating, or weight gain)
  • Lung problems (pain when you breathe, rapid heart rate, or feeling short of breath)
  • Signs of infection (easy bruising or bleeding, fever, chills, flu symptoms, stabbing chest pain, rapid and shallow breathing)
  • Signs of a blood clot (sudden numbness or weakness, problems with speech or balance, or chest pain)
  • Signs of stomach bleeding (coughing up blood or vomit that looks like coffee grounds and bloody or tarry stools)

Warnings and Precautions

• You must not take vitamin A supplements while you are taking this medicine.

• You will need to have regular blood tests during your treatment so that your doctor can monitor your blood lipids, blood cells, blood clotting, calcium levels and liver function.

• There is a risk of blood clots in the blood vessels during the first month of treatment with this medicine. You should let your doctor know if you get any redness, swelling or pain in your legs.

• Use this drug with caution in people with decreased kidney or liver function.

• This should not be used in people with rare hereditary problems of fructose intolerance.

• Let your doctor know if you are allergic to it or if you ever had an allergic reaction to the drug.

• This medicine should not be used during pregnancy as it causes birth defects. Your doctor may want you to have a pregnancy test before starting treatment.

• If you are breastfeeding women, consult your doctor first as well.