PMID- 34998209
OWN - NLM
STAT- MEDLINE
DCOM- 20220331
LR  - 20220401
IS  - 1879-2472 (Electronic)
IS  - 0049-3848 (Linking)
VI  - 210
DP  - 2022 Feb
TI  - Predictive factors for differentiating thrombohemorrhagic disorders in high-risk 
      acute promyelocytic leukemia.
PG  - 33-41
LID - S0049-3848(21)00579-X [pii]
LID - 10.1016/j.thromres.2021.12.020 [doi]
AB  - INTRODUCTION: Acute promyelocytic leukemia (APL) is often accompanied by 
      potentially fatal coagulopathy, especially in high-risk APL. Bleeding, 
      particularly severe bleeding is the leading cause of early death (ED). Meanwhile, 
      thrombosis, the other major coagulopathic complication, is being increasingly 
      recognized. However, predictors of thrombohemorrhagic disorders are still not 
      well investigated. MATERIALS AND METHODS: In this study, we retrospectively 
      studied 83 patients with high-risk APL and categorized them into severe bleeding, 
      thrombosis and no evident events groups. RESULTS: Severe bleeding was observed in 
      15 patients, nearly half of whom died of hemorrhage, while thrombosis was 
      observed in 12 patients. Risk factor analysis showed that high WBC 
      (>58.76 x 10(9)/L) (p = 0.001) and prolonged PT (>17.7 s) (p = 0.015) could be 
      independent predictors for severe bleeding, while high WBC/D-dimer>5.12 
      (p = 0.002) and low D-dimer/FIB<5.14 (p = 0.03) could be independent predictors 
      for thrombosis in high-risk APL patients. Moreover, there are significant 
      differences in WBC/D-dimer and D-dimer/FIB between DIC and Non-DIC groups 
      (p < 0.001). Notably, we found that the WBC/D-dimer was dramatically higher in 
      the thrombotic group than in the other two groups at the time of admission or 
      during the first week of induction therapy. CONCLUSIONS: High WBC and prolonged 
      PT could predict severe bleeding in high-risk APL patients, while high 
      WBC/D-dimer and low D-dimer/FIB could be independent predictors for thrombosis. 
      For high-risk APL, WBC/D-dimer and D-dimer/FIB are also beneficial in the 
      diagnosis of DIC. WBC/D-dimer might help early identification of thrombosis at 
      the time of admission or during the first week of induction therapy.
CI  - Copyright (c) 2022 Elsevier Ltd. All rights reserved.
FAU - Xiao, Mengyu
AU  - Xiao M
AD  - Department of Hematology, Zhengzhou University People's Hospital and Henan 
      Provincial People's Hospital, Henan, People's Republic of China.
FAU - Zhou, Pan
AU  - Zhou P
AD  - Department of Hematology, Zhengzhou University People's Hospital and Henan 
      Provincial People's Hospital, Henan, People's Republic of China.
FAU - Liu, Yanhui
AU  - Liu Y
AD  - Department of Hematology, Zhengzhou University People's Hospital and Henan 
      Provincial People's Hospital, Henan, People's Republic of China.
FAU - Wei, Shengjie
AU  - Wei S
AD  - Department of Hematology, Zhengzhou University People's Hospital and Henan 
      Provincial People's Hospital, Henan, People's Republic of China.
FAU - Li, Dan
AU  - Li D
AD  - Department of Hematology, Zhengzhou University People's Hospital and Henan 
      Provincial People's Hospital, Henan, People's Republic of China.
FAU - Li, Weiya
AU  - Li W
AD  - Department of Hematology, Zhengzhou University People's Hospital and Henan 
      Provincial People's Hospital, Henan, People's Republic of China.
FAU - Niu, Xiaona
AU  - Niu X
AD  - Department of Hematology, Zhengzhou University People's Hospital and Henan 
      Provincial People's Hospital, Henan, People's Republic of China.
FAU - Niu, Junwei
AU  - Niu J
AD  - Department of Hematology, Zhengzhou University People's Hospital and Henan 
      Provincial People's Hospital, Henan, People's Republic of China.
FAU - Zhang, Yinyin
AU  - Zhang Y
AD  - Department of Hematology, The First Affiliated Hospital of Zhengzhou University, 
      Henan, People's Republic of China.
FAU - Cao, Weijie
AU  - Cao W
AD  - Department of Hematology, The First Affiliated Hospital of Zhengzhou University, 
      Henan, People's Republic of China.
FAU - Liu, Bing
AU  - Liu B
AD  - Department of Clinical Laboratory, Henan Cancer Hospital, The Affiliated Cancer 
      Hospital of Zhengzhou University, Henan, People's Republic of China.
FAU - Wang, Xiaojiao
AU  - Wang X
AD  - Department of Central Laboratory, Henan Cancer Hospital, The Affiliated Cancer 
      Hospital of Zhengzhou University, Henan, People's Republic of China.
FAU - Bai, Yanliang
AU  - Bai Y
AD  - Department of Hematology, Zhengzhou University People's Hospital and Henan 
      Provincial People's Hospital, Henan, People's Republic of China.
FAU - Sun, Kai
AU  - Sun K
AD  - Department of Hematology, Zhengzhou University People's Hospital and Henan 
      Provincial People's Hospital, Henan, People's Republic of China. Electronic 
      address: sunkai@cellscience.org.
LA  - eng
PT  - Journal Article
DEP - 20211229
PL  - United States
TA  - Thromb Res
JT  - Thrombosis research
JID - 0326377
SB  - IM
MH  - *Disseminated Intravascular Coagulation/etiology
MH  - Hemorrhage/complications/etiology
MH  - Humans
MH  - *Leukemia, Promyelocytic, Acute/complications/diagnosis
MH  - Leukocyte Count
MH  - Retrospective Studies
MH  - *Thrombosis/etiology
OTO - NOTNLM
OT  - Acute promyelocytic leukemia
OT  - Disseminated intravascular coagulation
OT  - High-risk
OT  - Severe bleeding
OT  - Thrombosis
OT  - WBC/D-dimer
EDAT- 2022/01/09 06:00
MHDA- 2022/04/01 06:00
CRDT- 2022/01/08 20:16
PHST- 2021/08/28 00:00 [received]
PHST- 2021/10/22 00:00 [revised]
PHST- 2021/12/17 00:00 [accepted]
PHST- 2022/01/09 06:00 [pubmed]
PHST- 2022/04/01 06:00 [medline]
PHST- 2022/01/08 20:16 [entrez]
AID - S0049-3848(21)00579-X [pii]
AID - 10.1016/j.thromres.2021.12.020 [doi]
PST - ppublish
SO  - Thromb Res. 2022 Feb;210:33-41. doi: 10.1016/j.thromres.2021.12.020. Epub 2021 
      Dec 29.