Haemostatic parameters in acute promyelocytic leukemia patients treated with All Trans-Retinoic Acid (ATRA).
Kerbala Journal of Medicine,
Volume 1, Issue 0, Pages 63-68
AbstractBackground: Acute Pormyelocytic Leukemia (APL) is commonly associated with
Disseminated Intravascular Coagulation (DIC)
Objective: The work was conducted to identify patients with APL who show
laboratory evidence of DIC (clinical or subclinical) with serial laboratory follow up.
Subjects and Methods: In this study 44 newly diagnosed APL patients were included. For
each patient, full hemostatic investigations were done at time of diagnosis and repeated on
day 3 and day 7 of therapy.
Results: Before starting therapy, all patients had elevated levels of D-dimer, indicating the
presence of DIC. On day 7 of treatment, plasma D-dimer levels were normal in ATRA-
treated group, but were high in the chemotherapy treated group, indicating that DIC was
essentially resolved in ATRA treated patients.
Conclusion: DIC is commonly encountered at presentation in patients with APL,
necessitating a rapid and full coagulation study in all patients. ATRA therapy in APL
patients is associated with rapid improvement of coagulopathy, hence it will aid those
patients to pass quickly the critical period of DIC. Therefore, ATRA therapy is justified to
be used from day one of treatment in APL patients.
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