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Question

2.TY tolerates the first 2 weeks of treatment with ATRA and arsenic trioxide for her APL. She was doing well with normal mental status, diplopia resolving, and no bleeding. On day 15, the patient becomes hypoxic and develops fever. Chest CT scan demonstrates pulmonary infiltrates and a right-sided pleural effusion and mild pericardial effusion. She is transferred to ICU. What is the most likely diagnosis?

A. Pneumonia and associated parapneumonic effusion

B. Extramedullary leukemia

C. Transfusion-related acute long injury (TRALI)

D. Differentiation syndrome

E. Pulmonary edema due to volume overload