Acute promyelocytic leukemia presenting as recurrent venous and arterial thrombotic events: a case report and review of the literature

MacDougall, Kira; Chukkalore, Divya; Rehan, Maryam; Kashi, Meena; Bershadskiy, Alexander

doi:10.1080/20009666.2021.1973657

Cited by 4 publications

(5 citation statements)

References 41 publications

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“…foram relatados em pacientes com LPA na literatura, principalmente durante a terapia de indução de quimioterapia. 17 Xiao et al relataram que CGB/dímero-D alta (>5) e FIB/ dímero-D baixa (<5) poderiam ser preditores independentes para trombose em seu estudo em pacientes com LPA. 18 No caso que apresentamos, a relação FIB/dímero-D foi baixa em correlação com este estudo (1,1), mas diferentemente, a relação CGB/ dímero-D não foi alta (0,2).…”

Section: Discussionunclassified

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A Leucemia Mieloide Aguda Poderia ter se Apresentado Ainda Pior? “Causa Incomum de Trombose Multiarterial Concomitante”

Hazir¹,

Şimşek²,

Baldan³

et al. 2023

Arquivos Brasileiros De Cardiologia

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Section: Discussionunclassified

“…foram relatados em pacientes com LPA na literatura, principalmente durante a terapia de indução de quimioterapia. 17 …”

Section: Discussionunclassified

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A Leucemia Mieloide Aguda Poderia ter se Apresentado Ainda Pior? “Causa Incomum de Trombose Multiarterial Concomitante”

Hazir¹,

Şimşek²,

Baldan³

et al. 2023

Arquivos Brasileiros De Cardiologia

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“…6 Arterial thrombosis in APL patients mainly manifests as cerebral infarction, myocardial infarction, and ventricular thrombosis, while venous thrombosis can occur in the deep veins of the lower extremities, intracranial venous sinuses, and the manifestations of thrombosis and hemorrhage can also occur simultaneously as clinical signs of bleeding and coagulation disorders. [7][8][9][10][11] Effect of APL Therapeutic Agents on Coagulation-Anticoagulation Balance…”

Section: Mechanisms and Clinical Manifestations Of Apl-related Coagul...mentioning

confidence: 99%

Effect of Therapeutically Related Drugs on Coagulation-Anticoagulation Balance in Acute Promyelocytic Leukemia

Xiao

Zhou

Sun

2022

Clin Appl Thromb Hemost

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Acute promyelocytic leukemia (APL) usually presents with a series of coagulation-anticoagulation disturbance. Early administration of All-trans retinoic acid (ATRA) can reduce the risk of bleeding, but the potential for thrombosis needs to be addressed in some cases. The role of arsenic agent in correcting coagulation disorder remains to be studied, but oral arsenic agent shows potential advantages in coagulation recovery compared with intravenous agent, and chemotherapy can aggravate the progress of coagulation disease. In addition to early application of ATRA, avoiding invasive procedures and transfusion support can reduce the risk of bleeding. Whether the administration of heparin, thrombomodulin, recombinant factor VIIa or antifibrinolytics reduces the risk of bleeding and thrombosis associated with APL remains to be further explored, and their routine use outside of clinical trials is not recommended. This article reviews the effects of related drugs on coagulation-anticoagulation balance in APL patients.

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“…Thrombosis can affect any organ and involve either the arterial or venous systems. Ischemic stroke, as an exceptionally rare initial presentation of APL, is associated with a significantly high mortality rate [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Successful Management of Acute Promyelocytic Leukemia in a Patient Who Presented With Acute Ischemic Stroke on Top of Subdural Hematoma

Mallah,

Owda,

Hamayel

et al. 2023

Cureus

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Acute promyelocytic leukemia (APL), a distinct subtype of acute myelogenous leukemia (AML), is commonly associated with a heightened risk of bleeding due to coagulopathy. Thrombotic events, although less frequent, have also been linked to APL. However, the occurrence of ischemic stroke as an initial presentation of APL, particularly concomitant with central nervous system (CNS) bleeding, is exceedingly rare. The combination of these two complications is not reported in APL patients and is anticipated to carry a high mortality rate even with treatment. In this report, we describe the case of a young female patient with no significant medical history, who presented with decreased consciousness and recurrent seizures. Brain magnetic resonance imaging (MRI) revealed the simultaneous occurrence of acute ischemic stroke and acute-on-chronic subdural hematoma. The subsequent bone marrow biopsy confirmed the diagnosis of APL, displaying the characteristic positive promyelocytic leukemia (PML)-retinoic acid receptor alpha (RARA) t(15;17) translocation. The patient was promptly initiated on a high-risk AML-M3 protocol, coupled with supportive treatment through platelet transfusion. Remarkably, a favorable response to treatment was observed, and a marked improvement in her neurological parameters was observed within 2 weeks duration of treatment. Subsequent assessment through a bone marrow biopsy one month later revealed complete remission, with the PML-RARA fusion gene becoming negative following a single course of consolidation therapy.

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Acute promyelocytic leukemia presenting as recurrent venous and arterial thrombotic events: a case report and review of the literature

Cited by 4 publications

References 41 publications

A Leucemia Mieloide Aguda Poderia ter se Apresentado Ainda Pior? “Causa Incomum de Trombose Multiarterial Concomitante”

A Leucemia Mieloide Aguda Poderia ter se Apresentado Ainda Pior? “Causa Incomum de Trombose Multiarterial Concomitante”

Effect of Therapeutically Related Drugs on Coagulation-Anticoagulation Balance in Acute Promyelocytic Leukemia

Successful Management of Acute Promyelocytic Leukemia in a Patient Who Presented With Acute Ischemic Stroke on Top of Subdural Hematoma

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