Bleeding and thrombosis in acute promyelocytic leukemia

Acute promyelocytic leukemia (APL) has evolved from being a deadly to a highly curable disease, due totargeted molecular therapy with all‐trans retinoic acid (ATRA). As a result, the incidence of early hemorrhagic deaths for which APL is notorious has reduced to 5–10% as reported in clinical trials....

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Bibliographic Details
Published in:American journal of hematology 2012-06, Vol.87 (6), p.596-603
Main Authors: Choudhry, Aditi, DeLoughery, Thomas G.
Format: Article
Language:English
Subjects:
Antifibrinolytic Agents - therapeutic use
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
Arsenicals - therapeutic use
Biological and medical sciences
Blood Coagulation Tests
Clinical Trials as Topic
Combined Modality Therapy
Cysteine Endopeptidases - secretion
Disseminated Intravascular Coagulation - blood
Disseminated Intravascular Coagulation - diagnosis
Disseminated Intravascular Coagulation - etiology
Factor VIIa - therapeutic use
Factor VIII - therapeutic use
Fibrinogen - analysis
Fibrinogen - therapeutic use
Fibrinolysis
Hematologic and hematopoietic diseases
Hematology
Hemorrhage - etiology
Hemorrhage - mortality
Hemorrhage - prevention & control
Heparin - adverse effects
Heparin - therapeutic use
Humans
Leukemia, Promyelocytic, Acute - complications
Leukemia, Promyelocytic, Acute - drug therapy
Leukemia, Promyelocytic, Acute - metabolism
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Medical sciences
Multicenter Studies as Topic
Neoplasm Proteins - secretion
Oxides - therapeutic use
Plasma
Platelet Count
Platelet Transfusion
Recombinant Proteins - therapeutic use
Thromboplastin - secretion
Thrombosis - etiology
Treatment Failure
Tretinoin - adverse effects
Tretinoin - therapeutic use
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Description
Summary:Acute promyelocytic leukemia (APL) has evolved from being a deadly to a highly curable disease, due totargeted molecular therapy with all‐trans retinoic acid (ATRA). As a result, the incidence of early hemorrhagic deaths for which APL is notorious has reduced to 5–10% as reported in clinical trials. These results are not replicated outside of clinical trials as is evident from recent population‐based registries. High incidence of early hemorrhagic deaths remains the greatest contributor to treatment failure in this otherwise curable leukemia. Additionally, thrombosis is now being increasingly recognized in APL patients and may be associated with ATRA usage. Am. J. Hematol. 87:596–603, 2012. © 2012 Wiley Periodicals, Inc.
ISSN:0361-8609
1096-8652
DOI:10.1002/ajh.23158