[The impact of arsenic trioxide or all-trans retinoic acid treatment on coagulopathy in acute promyelocytic leukemia].
OBJECTIVE
To study the effect of arsenic trioxide (As2O3) or all-trans retinoic acid (ATRA) on coagulopathy in patients with acute promyelocytic leukemia (APL), and the mechanism of hemorrhage in these patients.


METHODS
Thrombomodulin (TM) or tissue factor (TF) transcription of mRNA of freshly isolated bone marrow blast from APL patients was detected by semi-quantitative RT-PCR. The parameters of coagulation and cell procoagulation activity (PCA) were assessed in plasmic levels. Bleeding symptom was observed during As2O3 or ATRA treatment.


RESULTS
TM expression in the APL cell surface was significantly upregulated from (14.31 +/- 1.60) ng/10(7) to (21.61 +/- 6.82) ng/10(7) cells. The levels of P-selectin, soluble fibrin monomer complex (SFMC) and D-dimer (D-D) decreased after ATRA or As2O3 treatment. Abnormal high expression of TF in APL cell was downregulated in patients treated with ATRA or As2O3. The expression level was (14.81 +/- 6.23) ng/L before treatment, but undetected after 20 days of treatment. In addition, the membrane PCA of fresh APL cells was predominantly FVII-dependent after ATRA or As2O3 treatment. Bleeding symptom was ameliorated during As2O3 or ATRA treatment.


CONCLUSIONS
Bleeding symptom was controlled in patients with APL after As2O3 or ATRA treatment.
Zhang
X
X
Department of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430032, China.
Zhou
H
H
Song
S
S
Qiao
Z
Z
Yang
L
L
Hu
Y
Y
D000328:Adult; D000970:Antineoplastic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000494:pharmacology* / Q000627:therapeutic use; D001778:Blood Coagulation Disorders / Q000188:drug therapy*; D015536:Down-Regulation; D005260:Female; D006470:Hemorrhage / Q000517:prevention & control*; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000150:complications* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010087:Oxides / Q000494:pharmacology* / Q000627:therapeutic use; D012333:RNA, Messenger / Q000235:genetics; D018180:Thrombomodulin / Q000235:genetics / Q000378:metabolism; D013925:Thromboplastin / Q000235:genetics / Q000378:metabolism; D014212:Tretinoin / Q000494:pharmacology* / Q000627:therapeutic use
D000970:Antineoplastic Agents; D001152:Arsenicals; D010087:Oxides; D012333:RNA, Messenger; D018180:Thrombomodulin; D014212:Tretinoin; D013925:Thromboplastin; D000077237:Arsenic Trioxide