Thrombosis in patients with acute promyelocytic leukemia treated with and without all-trans retinoic acid

Autor: Susan Escudier, Hagop M. Kantarjian, Elihu H. Estey
Rok vydání: 1996
Předmět:
Male
Cancer Research
Leukocytosis
medicine.medical_treatment
Myocardial Infarction
Gastroenterology
Cohort Studies
Neoplasms
Multiple Primary
Fatal Outcome
Leukemia
Promyelocytic
Acute
Antineoplastic Combined Chemotherapy Protocols
Melanoma
Disseminated intravascular coagulation
education.field_of_study
Antibiotics
Antineoplastic
Incidence
Remission Induction
Cytarabine
Hematology
Middle Aged
Leukemia
Treatment Outcome
Oncology
Infarction
Female
Germinoma
medicine.symptom
medicine.drug
Acute promyelocytic leukemia
Adult
Amsacrine
medicine.medical_specialty
Population
Antineoplastic Agents
Hemorrhage
Tretinoin
Internal medicine
Fibrinolysis
medicine
Idarubicin
Humans
education
neoplasms
Cerebral Hemorrhage
Retrospective Studies
Chemotherapy
business.industry
organic chemicals
Thrombosis
Disseminated Intravascular Coagulation
medicine.disease
biological factors
Immunology
business
Spleen
Zdroj: Leukemialymphoma. 20(5-6)
ISSN: 1042-8194
Popis: Laboratory evidence of disseminated intravascular coagulation (DIC) and/or fibrinolysis is present in the majority of patients with acute promyelocytic leukemia (APL). Historically, early hemorrhagic death (EHD) occurred in 10% to 30% of patients treated with chemotherapy. All-trans retinoic acid (ATRA), a differentiating agent, has a CR rate above 80% in patients, with ATRA-associated leukocytosis. We studied thrombotic events in this population and compared it to patients treated with chemotherapy alone. The results of studies using ATRA in patients with APL were reviewed. Patients received ATRA 45-50 mg/m(2) orally in two divided doses daily until complete remission. In newly diagnosed patients, Idarubicin 12 mg/m(2)/day was given intravenously for 4 to 5 days beginning on the fifth day of ATRA therapy or when the white blood cell count (WBC) was over 10x 10(3)/mu l. Thrombotic complications were noted in 3 of 31 patients during induction. Two died from thrombotic events during therapy with multiple thromboses documented at autopsy. ATRA syndrome was suspected in 2 of the patients with thromboses and only 1 of the patients without thrombosis. In previous studies, 1 of 25 APL patients treated with chemotherapy alone had thrombotic events during therapy. In conclusion, treatment of APL with ATRA may decrease the incidence of hemorrhagic complications, but does not eliminate thrombosis. While thrombotic events were not significantly increased in patients treated with ATRA, they were more common in patients suspected of having ATRA syndrome.
Databáze: OpenAIRE
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