PMID- 31370070
OWN - NLM
STAT- MEDLINE
DCOM- 20200127
LR  - 20200925
IS  - 1098-9064 (Electronic)
IS  - 0094-6176 (Linking)
VI  - 45
IP  - 6
DP  - 2019 Sep
TI  - The Role of Abnormal Hemostasis and Fibrinolysis in Morbidity and Mortality of 
      Acute Promyelocytic Leukemia.
PG  - 612-621
LID - 10.1055/s-0039-1693478 [doi]
AB  - Despite the improved therapeutic advances in the management of acute 
      promyelocytic leukemia (APL), a significant early mortality during induction, 
      also referred to as early death (ED), remains an obstacle for further improvement 
      in outcome. Hemorrhagic complications are the most common cause of morbidity and 
      mortality. Perturbed hemostatic dysfunction is present as the result of 
      abnormalities in both the coagulation and the fibrinolytic systems. The 
      activation of coagulation is distinct from the classical disseminated 
      intravascular coagulation. Multiple abnormalities in the fibrinolytic system have 
      recently been identified. The most significant change is increased production of 
      tissue plasminogen activator (tPA) and its receptor annexin A2 by the APL 
      promyelocytes. Among the hemorrhagic complications, intracranial hemorrhage 
      predominates. The pathogenesis of this catastrophic event is elucidated by new 
      evidence of adverse effect of tissue plasminogen activator (tPA) on the brain, 
      including both the plasmin-dependent and plasmin-independent pathways. In order 
      to address the hemorrhagic complications, a thorough understanding of the 
      hemostatic dysfunction is essential. In this article, our current concept of the 
      abnormal hemostasis in APL is reviewed. The failure to reduce the early death 
      rate, despite the introduction of effective therapy, will also be discussed.
CI  - Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
FAU - Kwaan, Hau C
AU  - Kwaan HC
AD  - Division of Hematology-Oncology, Feinberg School of Medicine, Northwestern 
      University, Chicago, Illinois.
FAU - Weiss, Ivy
AU  - Weiss I
AD  - Division of Hematology-Oncology, Feinberg School of Medicine, Northwestern 
      University, Chicago, Illinois.
FAU - Tallman, Martin S
AU  - Tallman MS
AD  - Leukemia Service, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical 
      College, New York, New York.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20190801
PL  - United States
TA  - Semin Thromb Hemost
JT  - Seminars in thrombosis and hemostasis
JID - 0431155
SB  - IM
MH  - Fibrinolysis/*immunology
MH  - Hemostasis/*immunology
MH  - Humans
MH  - Leukemia, Promyelocytic, Acute/*mortality
MH  - Morbidity
MH  - Survival Rate
COIS- None.
EDAT- 2019/08/02 06:00
MHDA- 2020/01/28 06:00
CRDT- 2019/08/02 06:00
PHST- 2019/08/02 06:00 [pubmed]
PHST- 2020/01/28 06:00 [medline]
PHST- 2019/08/02 06:00 [entrez]
AID - 10.1055/s-0039-1693478 [doi]
PST - ppublish
SO  - Semin Thromb Hemost. 2019 Sep;45(6):612-621. doi: 10.1055/s-0039-1693478. Epub 
      2019 Aug 1.