期刊
MEDICAL ONCOLOGY
卷 30, 期 1, 页码 -出版社
HUMANA PRESS INC
DOI: 10.1007/s12032-013-0478-y
关键词
Acute promyelocytic leukemia; Hemorrhagic early death; ISTH DIC score; ATRA
类别
资金
- Ministry of Education and Science, Republic of Serbia [41004]
High-hemorrhagic early death (ED) rate is a major impediment in the managing of acute promyelocytic leukemia (APL). In our group of 56 newly diagnosed APL patients, ED occurred in 12 subjects, due to endocranial bleeding (8/12), differentiation syndrome (2/12), or infection (2/12). Predictors of hemorrhagic ED were as follows: white blood cells count >= 20 9 10(9)/L (P = 0.002337), Eastern cooperative oncology group performance status >= 3 (P = 0.00173), fibrinogen level <2 g/L (P = 0.004907), prothrombin time <50% (P = 0.0124), and International Society of Thrombosis and Hemostasis Scoring System for disseminated intravascular coagulation (ISTH DIC score) >= 6 (P = 0.00741). Multivariate analysis indicated ISTH DIC score >= 6 to be the most significant predictor for hemorrhagic ED (P = 0.008). The main finding of this study is that simple coagulation-related tests, performed on hospital admission and combined in the ISTH DIC score, might help to identify patients at high risk for fatal bleeding needing more aggressive supportive measures.
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