[Hemostatic changes during the treatment of acute promyelocytic leukemia with all-transretinoic acid].
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.
Medvedeva
N A
NA
Cherepanova
V V
VV
Tarasova
L N
LN
Kudriavtseva
A V
AV
Kostin
A I
AI
Kolupaeva
O R
OR
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*
D000970:Antineoplastic Agents; D014212:Tretinoin