PMID: 11921015Mar 29, 2002Paper

Abnormalities in hemostasis in acute promyelocytic leukemia

Hematological Oncology
Hau C KwaanLisa N Boggio

Abstract

Our understanding of the hemostatic abnormalities in acute promyelocytic leukemia (APL) has undergone remarkable changes over the past three decades. Hemorrhagic complications lead to significant morbidity and mortality in patients with APL. Up to 30% of early deaths are due to hemorrhagic complications. Our concept of the coagulation changes in APL have evolved from a simple belief that the bleeding was due to disseminated intravascular coagulation (DIC) from underlying infection, to a knowledge that the APL cells themselves are responsible for the bleeding. We have observed that apoptotic APL cells have increased generation of thrombin and therefore contribute to the hypercoagulability and DIC. In addition, excessive fibrinolysis has been recognized to play an important role. The advent of a new therapeutic approach with all-trans-retinoic acid has improved overall survival and has greatly shortened the hemorrhagic phase of the disease, but only to produce a new complication, the retinoic acid syndrome. Its pathogenesis and management still remain to be the challenge for the present.

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Citations

Feb 6, 2010·Proceedings of the National Academy of Sciences of the United States of America·Jinsong YanXiaodong Xi
Nov 21, 2007·Hematology·Hau C Kwaan
Oct 1, 2011·Nanomedicine·Marina A DobrovolskaiaScott E McNeil
Jun 8, 2014·Best Practice & Research. Clinical Haematology·Hau C Kwaan, Elizabeth H Cull
Mar 17, 2009·Best Practice & Research. Clinical Haematology·Eytan SteinMartin S Tallman
Feb 3, 2005·British Journal of Haematology·Eva Birgitte LeinoeHans Erik Johnsen
Aug 2, 2003·Clinical and Laboratory Haematology·E KalkP Rose
Nov 5, 2011·British Journal of Haematology·Karen A BreenBeverley J Hunt
Jan 28, 2010·Journal of Thrombosis and Haemostasis : JTH·J ZhouG E Gilbert
Oct 3, 2006·Leukemia Research·Nicole ReischFuat Oduncu
Mar 12, 2003·Hematology/oncology Clinics of North America·Hau C Kwaan, Chadi Nabhan
Nov 3, 2012·Journal of Biomedicine & Biotechnology·Patricia A MadureiraDavid M Waisman
Jun 9, 2017·Clinical Chemistry and Laboratory Medicine : CCLM·Renáta HudákJános Kappelmayer
Aug 4, 2009·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Hideki NomuraTsutomu Nobori
Oct 4, 2008·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Maria CicconeAntonio Cuneo
May 26, 2006·Circulation Journal : Official Journal of the Japanese Circulation Society·Masahito SakumaKunio Shirato

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