Coagulation patterns of disseminated intravascular coagulation in acute promyelocytic leukemia

Abstract

Coagulation patterns of 19 newly-diagnosed acute promyelocytic leukemia (APL) patients with disseminated intravascular coagulation (DIC) at presentation were studied. Seventeen patients had hemorrhagic complications, of which four were fatal. Fatal hemorrhages were related with lower fibrinogen level and lower platelet count. DIC of the APL patients without infection was characterized by low fibrinogen and normal antithrombin III (ATIII) level. Thrombin-ATIII complex level was elevated in all patients examined. Patients with infection had higher fibrinogen levels than those without infection and some patients had reduced ATIII level. Ten remission inductions were tried with multidrug chemotherapy and seven with all-trans retinoic acid (ATRA). Complete remission was achieved in seven of ten inductions with chemotherapy and in all seven inductions with ATRA. Two patients treated with chemotherapy had fatal hemorrhage after starting therapy but none treated with ATRA.

The Role of Platelets in Cancer-Related Bleeding Risk: A Systematic Review

“…[135][136][137][138][139][140][141][142][143][144] There were 3 posthoc studies on data from randomized controlled trials, 104,117,120 2 case series 111,112 and 47 cohort studies, among which data were collected prospectively in 24 96,97,99,105-110,113,115,116,118,123,126,127 129-131,135,136,140,142,144 and obtained from medical records in 23. 2, 94,95,98,100-103,114,119,121,122,124,125,128,132-134,137-139 141,143 Platelet count only was reported in 40 studies, 2, 94,95,97,98,[100][101][102][103][104][105]107,114,[116][117][118][119][120][121][122][124][125][126][127][128][129][130][131][132][133][134]…”

“…61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 Thus, 52 studies were included for quality assessment and data extraction. 2 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 …”

“…Studies included patients with hematological malignancy ( n = 31), 2 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 solid tumors ( n = 11), 124 125 126 127 128 129 130 131 132 133 134 or both ( n = 10). 135 136 137 138 139 140 141 142 143 144 There were 3 posthoc studies on data from randomized controlled trials, 104 117 120 2 case series 111 112 and 47 cohort studies, among which data were collected prospectively in 24 96 97 99 105 106 107 108 109 110 113 115 116 118 123 126…”

“…135 136 137 138 139 140 141 142 143 144 There were 3 posthoc studies on data from randomized controlled trials, 104 117 120 2 case series 111 112 and 47 cohort studies, among which data were collected prospectively in 24 96 97 99 105 106 107 108 109 110 113 115 116 118 123 126 127 129 130 131 135 136 140 142 144 and obtained from medical records in 23. 2 94 95 98 100 101 102 103 114 119 121 122 124 125 128 132 133 134 137 138 139 141 143 Platelet count only was reported in 40 studies, 2 94 95 97 98 100 101 102 103 104 105 …”

“…Of the included studies, 23 were rated good, 95 98 99 104 105 108 109 113 114 117 120 123 127 128 130 131 135 136 140 141 142 143 144 25 were rated fair, 94 96 97 100 101 102 103 106 107 110 115 116 118 119 121 122 124 125 126 132 133 134 137 138 139 and 4 were rated poor. 2 111 112 129 Data from studies rating good or fair are presented in this review; however, only studies rating good are displayed in Tables 1 2 3 and Fig.…”