Significance of fibrinogen, D-dimer, and LDH levels in predicting the risk of bleeding in patients with acute promyelocytic leukemia.
This study was performed to determine whether any clinical parameters measured at diagnosis or during treatment are associated with bleeding in patients with acute promyelocytic leukemia (APL). Ninety patients with APL who were treated with all-transretinoic acid (ATRA) and anthracycline-based chemotherapy were analyzed. There were 24 significant bleeding events, classified by onset as 'hyperacute' (n = 5), 'acute' (n = 11) and 'late' (n = 8). Fifteen patients (17%) died because of bleeding. A poor fibrinogen (FBG) response during ATRA and chemotherapy was associated with an increased risk of bleeding (p = 0.003). Increased LDH and decreased FBG levels were associated with an increased incidence of bleeding, and low PLT count was correlated with death from bleeding. Our findings suggest that LDH/FBG levels and FBG response may be associated with morbidity and mortality from bleeding in patients with APL.
Kim
Dae-Young
DY
Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul 138-736, Republic of Korea.
Lee
Je-Hwan
JH
Lee
Jung-Hee
JH
Kim
Sung-Doo
SD
Lim
Sung-Nam
SN
Choi
Yunsuk
Y
Lee
Young-Shin
YS
Kang
Young-Ah
YA
Seol
Miee
M
Jeon
Mijin
M
Kim
Joo Youn
JY
Lee
Kyung-Hwa
KH
Lee
Yeon-Joo
YJ
Lee
Kyoo-Hyung
KH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018943:Anthracyclines / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis* / Q000378:metabolism; D005340:Fibrinogen / Q000032:analysis* / Q000378:metabolism; D006470:Hemorrhage / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007770:L-Lactate Dehydrogenase / Q000032:analysis* / Q000097:blood; D015473:Leukemia, Promyelocytic, Acute / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014212:Tretinoin / Q000627:therapeutic use; D055815:Young Adult
D018943:Anthracyclines; D000970:Antineoplastic Agents; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D014212:Tretinoin; D005340:Fibrinogen; D007770:L-Lactate Dehydrogenase