title: Significance of fibrinogen, D-dimer, and LDH levels in predicting the risk of bleeding in patients with acute promyelocytic leukemia.
abstract: 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.
authors.affiliation: Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul 138-736, Republic of Korea.
authors.forename: Dae-Young
authors.initials: DY
authors.lastname: Kim
authors.forename: Je-Hwan
authors.initials: JH
authors.lastname: Lee
authors.forename: Jung-Hee
authors.initials: JH
authors.lastname: Lee
authors.forename: Sung-Doo
authors.initials: SD
authors.lastname: Kim
authors.forename: Sung-Nam
authors.initials: SN
authors.lastname: Lim
authors.forename: Yunsuk
authors.initials: Y
authors.lastname: Choi
authors.forename: Young-Shin
authors.initials: YS
authors.lastname: Lee
authors.forename: Young-Ah
authors.initials: YA
authors.lastname: Kang
authors.forename: Miee
authors.initials: M
authors.lastname: Seol
authors.forename: Mijin
authors.initials: M
authors.lastname: Jeon
authors.forename: Joo Youn
authors.initials: JY
authors.lastname: Kim
authors.forename: Kyung-Hwa
authors.initials: KH
authors.lastname: Lee
authors.forename: Yeon-Joo
authors.initials: YJ
authors.lastname: Lee
authors.forename: Kyoo-Hyung
authors.initials: KH
authors.lastname: Lee
mesh_terms: 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
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D014212:Tretinoin; D005340:Fibrinogen; D007770:L-Lactate Dehydrogenase