PMID- 29771870
OWN - NLM
STAT- MEDLINE
DCOM- 20181009
LR  - 20181114
IS  - 1643-3750 (Electronic)
IS  - 1234-1010 (Print)
IS  - 1234-1010 (Linking)
VI  - 24
DP  - 2018 May 17
TI  - Hyperfibrinolysis Is an Important Cause of Early Hemorrhage in Patients with 
      Acute Promyelocytic Leukemia.
PG  - 3249-3255
LID - 10.12659/MSM.909938 [doi]
AB  - BACKGROUND The objective of the current study was to guide the early clinical 
      treatment strategies by assessing the recovery of abnormal coagulation in acute 
      promyelocytic leukemia (APL) patients during induction therapy. MATERIAL AND 
      METHODS Retrospective analysis was performed in 112 newly-diagnosed patients with 
      APL during induction treatment. RESULTS The early death (ED) rate in our study 
      was 5.36% and the main cause was fetal hemorrhage. The presence of bleeding 
      symptoms was significantly correlated with low platelet and fibrinogen levels. 
      The values of white blood cell (WBC), lactate dehydrogenase (LDH), prothrombin 
      time (PT), fibrinogen, and bone marrow leukemic promyelocyte in the high-risk 
      group were significantly different from those in the low/intermediate-risk 
      groups. Coagulation variables significantly improved after dual induction 
      therapy. No significant difference was found in changes of platelet (PLT), 
      prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimers, 
      and fibrinogen among different risk groups after induction therapy. D-dimer 
      levels were initially high and remained well above normal after 4 weeks of 
      induction therapy. CONCLUSIONS Aggressive prophylactic transfusion to maintain 
      high platelet and fibrinogen transfusion thresholds could reduce hemorrhage in 
      APL patients. Immediately starting induction therapy effectively alleviated 
      coagulopathy in APL patients. Hyperfibrinolysis was a more important event in the 
      APL hemorrhagic diathesis.
FAU - Song, Yu-Hua
AU  - Song YH
AD  - Department of Hematology, The Second Hospital of Nanjing, Nanjing, Jiangsu, China 
      (mainland).
FAU - Qiao, Chun
AU  - Qiao C
AD  - Department of Hematology, The First Affiliated Hospital of Nanjing Medical 
      University, Jiangsu Province Hospital, Nanjing, Jiangsu, China (mainland).
AD  - Department of Hematology, The First Affiliated Hospital of Nanjing Medical 
      University, , China (mainland).
FAU - Xiao, Li-Chan
AU  - Xiao LC
AD  - Department of Hematology, The First Affiliated Hospital of Nanjing Medical 
      University, Jiangsu Province Hospital, Nanjing, Jiangsu, China (mainland).
FAU - Zhang, Run
AU  - Zhang R
AD  - Department of Hematology, The First Affiliated Hospital of Nanjing Medical 
      University, Jiangsu Province Hospital, Nanjing, Jiangsu, China (mainland).
FAU - Lu, Hua -
AU  - Lu H-
AD  - Department of Hematology, The First Affiliated Hospital of Nanjing Medical 
      University, Jiangsu Province Hospital, Nanjing, Jiangsu, China (mainland).
LA  - eng
PT  - Journal Article
DEP - 20180517
PL  - United States
TA  - Med Sci Monit
JT  - Medical science monitor : international medical journal of experimental and 
      clinical research
JID - 9609063
RN  - 0 (Hemostatics)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Child
MH  - Female
MH  - *Fibrinolysis/drug effects
MH  - Hemorrhage/*etiology
MH  - Hemostatics/pharmacology/therapeutic use
MH  - Humans
MH  - Leukemia, Promyelocytic, Acute/*complications/drug therapy
MH  - Male
MH  - Middle Aged
MH  - Risk Factors
MH  - Young Adult
PMC - PMC5985706
EDAT- 2018/05/18 06:00
MHDA- 2018/10/10 06:00
PMCR- 2018/05/17
CRDT- 2018/05/18 06:00
PHST- 2018/05/18 06:00 [entrez]
PHST- 2018/05/18 06:00 [pubmed]
PHST- 2018/10/10 06:00 [medline]
PHST- 2018/05/17 00:00 [pmc-release]
AID - 909938 [pii]
AID - 10.12659/MSM.909938 [doi]
PST - epublish
SO  - Med Sci Monit. 2018 May 17;24:3249-3255. doi: 10.12659/MSM.909938.