Development of fatal APL differentiation syndrome. May cause QT prolongation & complete AV block which can lead to torsade de pointes-type ventricular arrhythmia. Prior to initiating therapy, perform a 12-lead ECG & assess serum electrolytes (K, Ca, & Mg) & creatinine; correct preexisting electrolyte abnormalities & discontinue use of possible QT prolonging drugs. During therapy, K conc should be kept ≥4 mEq/L & Mg conc ≥1.8 mg/dL. If syncope, rapid or irregular heartbeat develops, patient should be hospitalized for monitoring. Development of hyperleukocytosis. Complete AV block. Monitor electrolyte, hematologic & coagulation profiles at least twice wkly, ECGs wkly & more frequently for clinically unstable patients. Human carcinogen. Renal or hepatic impairment. Concomitant use w/ medications prolonging QT interval or lead to electrolyte abnormalities. Pregnancy & lactation. Childn <5 yr.
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