Bleeding and thrombosis in acute promyelocytic leukemia

Choudhry, Aditi; DeLoughery, Thomas G.

doi:10.1002/ajh.23158

Cited by 108 publications

(69 citation statements)

References 102 publications

(170 reference statements)

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“…A similar rate was found by another metaanalysis performed by the same group in adult ALL, in which an overall VTE incidence of 5.9% during remission induction therapy was reported [35]. A particular consideration deserves acute promyelocytic leukemia (APL), in which thrombosis and bleeding manifestations may occur concomitantly as a part of the same thrombo-hemorrhagic syndrome [36][37][38][39]. Patients with APL have profound abnormalities of hemostatic parameters including hypofibrinogenemia, prolonged prothrombin and thrombin time and increased circulating levels of fibrinogenfibrin degradation products [37].…”

Section: Search Methodssupporting

confidence: 63%

Thromboembolic risk in hematological malignancies

Franchini

2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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There are a growing number of studies documenting that, similarly to patients with solid cancers, also patients with hematological malignancies (i.e., acute leukemia, lymphoproliferative and myeloproliferative neoplasms and plasma cell disorders) are at increased risk of thrombosis. The pathogenesis of the hypercoagulable state associated with hematological cancers is often multifactorial. Contributor factors include tumor cell-derived procoagulants, antineoplastic therapies, central venous catheters, concomitant infections and advanced age. In this narrative review, the epidemiology, pathogenesis and management of thrombosis in patients with hematological malignancies are reviewed.

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Section: Search Methodssupporting

confidence: 63%

Thromboembolic risk in hematological malignancies

Franchini

2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…Coagulation disorders are frequently observed in APL and can also occur in other AL subtypes (28)(29)(30). The pathogenic mechanism underlying the blood coagulation disorder in these patients is complex.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of D-dimer and lactate dehydrogenase plasma levels in patients with relapsed acute leukemia

Wang

Yang

2016

Oncology Letters

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Abstract. Despite the outstanding advances made over the past decade regarding our knowledge of acute leukemia (AL), relapsed AL remains to be associated with a dismal prognosis. A better understanding of AL relapse and monitoring of the D-dimer and lactate dehydrogenase (LDH) plasma levels following chemotherapy may aid clinicians in determining whether relapse may occur in the subsequent phases of the disease. The present study evaluated D-dimer and LDH levels in 204 patients with relapsed AL. Data were collected at the initial onset of AL, at complete remission (CR) and in patients with relapsed AL. D-dimer plasma levels were significantly increased in patients with initial AL and in patients with relapsed AL (P=0.005 and P=0.007, respectively) but not in those with CR. LDH levels were significantly increased in AL patients at the initial onset of disease and at relapse compared with patients achieving CR, irrespective of cell type. Plasma prothrombin time, activated partial thromboplastin time and fibrinogen levels were not significantly different across patients (with the exception of acute promyelocytic leukemia patients) at the initial onset, relapsed AL or CR. Routine hematological parameters (white blood cell count, hemoglobin, platelet count) were significantly different at the initial onset of AL (P=0.002, P<0.001 and P=0.001, respectively) and during relapsed AL (P=0.009, P=0.003 and P<0.001, respectively) compared with patients achieving CR, suggesting an association between D-dimer, LDH and relapsed AL. These results also indicate that determination of D-dimer and LDH levels may be useful for predicting the probability of relapse during chemotherapy, but should also be combined with routine hematological parameters.

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“…41,42 In this condition, however, thrombosis and bleeding manifestations might occur concomitantly as a part of the same thrombohemorrhagic syndrome. The bleeding complications are particularly severe in the microgranular variant, which is characterized by hyperleukocytosis.…”

Section: Incidence Of Thromboembolic Events In Acute Leukemiasmentioning

confidence: 95%