title: Acute promyelocytic leukemia. Management of the coagulopathy during daunorubicin-prednisone remission induction.
abstract: Seven adults with acute promyelocytic leukemia (APL) and disseminated intravascular coagulation were treated for remission induction with daunorubicin hydrochloride and prednisone. In all patients the coagulopathy was managed with continuous-infusion heparin sodium and vigorous transfusion with platelets, cryoprecipitate, and fresh frozen plasma. Five patients survived induction; they all achieved complete remission (CR). Median duration of CR was 27 + months; two patients presently survive in their initial CR at 28 and 48 months. Recognition of APL as a distinct type of acute leukemia and prompt initiation of treatment aimed at rapid cytoreduction and control of the coagulopathy has resulted in a prolonged disease-free survival for the majority of patients.
mesh_terms: D000293:Adolescent; D000328:Adult; D001779:Blood Coagulation Factors; D001780:Blood Coagulation Tests; D011232:Chemical Precipitation; D003630:Daunorubicin / Q000627:therapeutic use*; D004211:Disseminated Intravascular Coagulation / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010949:Plasma; D011241:Prednisone / Q000627:therapeutic use*; D012075:Remission, Spontaneous
chemical_list: D001779:Blood Coagulation Factors; D006493:Heparin; D011241:Prednisone; D003630:Daunorubicin