title: Bleeding and thrombosis in acute promyelocytic leukemia.
abstract: Acute promyelocytic leukemia (APL) has evolved from being a deadly to a highly curable disease, due to targeted molecular therapy with all-trans retinoic acid (ATRA). As a result, the incidence of early hemorrhagic deaths for which APL is notorious has reduced to 5-10% as reported in clinical trials. These results are not replicated outside of clinical trials as is evident from recent population-based registries. High incidence of early hemorrhagic deaths remains the greatest contributor to treatment failure in this otherwise curable leukemia. Additionally, thrombosis is now being increasingly recognized in APL patients and may be associated with ATRA usage.
authors.affiliation: Legacy Emanuel and Legacy Good Samaritan Hospitals Internal Medicine Residency Training Program, 3181 SW Sam Jackson Park Road, Portland, OR 97201-3098, USA.
authors.forename: Aditi
authors.initials: A
authors.lastname: Choudhry
authors.forename: Thomas G
authors.initials: TG
authors.lastname: DeLoughery
mesh_terms: D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000627:therapeutic use; D001780:Blood Coagulation Tests; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003546:Cysteine Endopeptidases / Q000378:metabolism; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D005169:Factor VIII / Q000627:therapeutic use; D015942:Factor VIIa / Q000627:therapeutic use; D005340:Fibrinogen / Q000032:analysis / Q000627:therapeutic use; D005342:Fibrinolysis; D006470:Hemorrhage / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism; D015337:Multicenter Studies as Topic; D009363:Neoplasm Proteins / Q000378:metabolism; D010087:Oxides / Q000627:therapeutic use; D010949:Plasma; D010976:Platelet Count; D017713:Platelet Transfusion; D011994:Recombinant Proteins / Q000627:therapeutic use; D013925:Thromboplastin / Q000378:metabolism; D013927:Thrombosis / Q000209:etiology*; D017211:Treatment Failure; D014212:Tretinoin / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000933:Antifibrinolytic Agents; D000970:Antineoplastic Agents; D001152:Arsenicals; D009363:Neoplasm Proteins; D010087:Oxides; D011994:Recombinant Proteins; C026912:cryoprecipitate coagulum; D014212:Tretinoin; D005169:Factor VIII; D005340:Fibrinogen; D006493:Heparin; D013925:Thromboplastin; C103587:recombinant FVIIa; D015942:Factor VIIa; D003546:Cysteine Endopeptidases; C030910:cancer procoagulant; D000077237:Arsenic Trioxide