2019
DOI: 10.1055/s-0039-1693478
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The Role of Abnormal Hemostasis and Fibrinolysis in Morbidity and Mortality of Acute Promyelocytic Leukemia

Abstract: 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 diss… Show more

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Cited by 38 publications
(34 citation statements)
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“…Primary hyper‐fibrinolysis is a common feature of acute promyelocytic leukaemia. These patients often present with severe hyper‐fibrinolysis and bleeding due to increased plasminogen activation on the malignant cell surface 44 . Hyper‐fibrinolysis has also been described among patients with solid tumours, e.g.…”
Section: Pathophysiologymentioning
confidence: 99%
“…Primary hyper‐fibrinolysis is a common feature of acute promyelocytic leukaemia. These patients often present with severe hyper‐fibrinolysis and bleeding due to increased plasminogen activation on the malignant cell surface 44 . Hyper‐fibrinolysis has also been described among patients with solid tumours, e.g.…”
Section: Pathophysiologymentioning
confidence: 99%
“…17 Although in APL similar thromboinflammatory mechanisms are operational, APL also has certain distinctly different features as the leukemic cells express not only tissue factor but also annexin 2 that binds and activates plasminogen, which together with a lower plasma level of thrombin-activatable fibrinolytic inhibitor aggravates fibrinolysis. 18 These factors likely contribute to the high bleeding risk in APL.…”
Section: Pathophysiologymentioning
confidence: 99%
“…While PML-RARA induced a high expression of ANXA8 in APL [ 40 , 78 , 79 ], RA-induced downregulation of ANXA2 expression in myeloid leukemia cell lines was not confined to APL. Notably, high levels of ANXA2 in hyperfibrinolysis could be corrected by RA or RA plus ATO therapy in patients with APL [ 80 , 81 , 82 ].…”
Section: Ra and Annexins In Myelopoiesis And Acute Promyelocytic Lmentioning
confidence: 99%