title: [Hemostatic changes during the treatment of acute promyelocytic leukemia with all-transretinoic acid].
abstract: OBJECTIVE
  To study hemostasis in ATRA treatment of acute promyelocytic leukemia (APL).
  
  
  METHODS
  Hemostasis was studied in 8 newly admitted APL patients treated with ATRA. All of them had hemorrhages, thrombocytopenia 5-15 x 10(9)/l at diagnosis, laboratory signs of the DIC syndrome at induction therapy.
  
  
  RESULTS
  Hemorrhage arresting was seen on the ATRA therapy day 14 to 30. Duration of thrombocytopenia under 20 x 10(9)/l was 5.8 +/- 1.8 days. After 7 days of ATRA therapy coagulation tests improved with some hypercoagulation tendency. Subsequent condition of hemostasis was considered as normo/hypercoagulation accompanied by constant thrombin persistence (in the presence of FDP) and depression of hageman-dependent fibrinolysis even in remission. A case of ileofemoral thrombosis followed by fatal thromboembolism of the pulmonary artery is reported.
  
  
  CONCLUSIONS
  It is suggested to use heparin, especially low molecular weight heparin when there are signs of hypercoagulation in APL patients.
authors.forename: N A
authors.initials: NA
authors.lastname: Medvedeva
authors.forename: V V
authors.initials: VV
authors.lastname: Cherepanova
authors.forename: L N
authors.initials: LN
authors.lastname: Tarasova
authors.forename: A V
authors.initials: AV
authors.lastname: Kudriavtseva
authors.forename: A I
authors.initials: AI
authors.lastname: Kostin
authors.forename: O R
authors.initials: OR
authors.lastname: Kolupaeva
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D005260:Female; D006487:Hemostasis / Q000187:drug effects*; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000097:blood* / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D013921:Thrombocytopenia / Q000097:blood / Q000139:chemically induced; D013997:Time Factors; D014212:Tretinoin / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000970:Antineoplastic Agents; D014212:Tretinoin