scholarly journals Acute Promyelocytic Leukemia: Results of Treatment by Daunorubicin

Blood ◽  
1973 ◽  
Vol 41 (4) ◽  
pp. 489-496 ◽  
Author(s):  
Jean Bernard ◽  
Marise Weil ◽  
Michel Boiron ◽  
Claude Jacquillat ◽  
Georges Flandrin ◽  
...  
Keyword(s):  
Acute Promyelocytic Leukemia ◽  
Median Duration ◽  
Disseminated Intravascular Coagulation ◽  
Promyelocytic Leukemia ◽  
The Other ◽  
Intravascular Coagulation ◽  
Results Of Treatment

Abstract Daunorubicin induces complete remissions in about 50% of patients with acute promyelocytic leukemia. The median duration of these remission is 26 mo. Failures are mainly due to hemorrhages as a result of disseminated intravascular coagulation during the first 5 days (25%) or due to sepsis during the second and third week (25%). Long-term survivals are more frequent than in the other acute granulocytic leukemias.

scholarly journals The specific activity of plasminogen activator inhibitor-1 in disseminated intravascular coagulation with acute promyelocytic leukemia

Blood ◽  
1991 ◽  
Vol 77 (9) ◽  
pp. 1949-1957 ◽  
Author(s):  
Y Sakata ◽  
T Murakami ◽  
A Noro ◽  
K Mori ◽  
M Matsuda
Keyword(s):  
Plasminogen Activator ◽  
Acute Promyelocytic Leukemia ◽  
Disseminated Intravascular Coagulation ◽  
Specific Activity ◽  
Plasminogen Activator Inhibitor ◽  
Promyelocytic Leukemia ◽  
Plasminogen Activator Inhibitor 1 ◽  
Intravascular Coagulation ◽  
Activator Inhibitor ◽  
Pai 1

In disseminated intravascular coagulation (DIC) with acute promyelocytic leukemia (APL) in the absence of severe infection, marked fibrinolysis was noted in comparison with normal levels of antithrombin III, which is a major inhibitor of the coagulation system. Increased plasminogen activator inhibitor-1 (PAI-1) antigen levels in plasma from patients with septicemia decreased the ratio of the plasma clot lysis rate induced by an anti-alpha 2-plasmin inhibitor monoclonal antibody to the tissue-type plasminogen activator (t-PA) concentration. This decrease was not as prominent in plasma from patients with DIC, especially those with APL. To explore the character of PAI-1 in these plasmas, we measured the specific activity of PAI-1 by determining the ratio of active PAI-1 antigen to t-PA-unbound PAI-1 antigen. To calculate the amount of active PAI-1 antigen, the amount of t-PA/PAI-1 complex before and after the addition of a fixed amount of t-PA to the sample was measured by a sandwich solid-phase enzyme-linked immunosorbent assay using anti-PAI-1 and anti-t-PA monoclonal antibodies. The assay to measure total PAI-1 antigen used three monoclonal anti-PAI-1 antibodies and had similar sensitivities to free active, latent, vitronectin-bound and t-PA-bound PAI-1. The specific activity of PAI-1 decreased in patients with DIC (43.7% +/- 30.6%) and in DIC cases with APL (10.3% +/- 6.0%) in comparison to patients with septicemia (83.7% +/- 20.2%) or normal controls (85.8% +/- 27.3%). In DIC associated with APL, degraded forms of PAI-1 were detected in plasma by immunoblotting. These results suggest that a decrease in the specific activity of PAI-1 and an increase in secondary fibrinolysis result in a hyperfibrinolytic state in DIC patients with APL.

scholarly journals Disseminated Intravascular Coagulation With Purpura Fulminans Presentation of Acute Promyelocytic Leukemia

2019 ◽  
Vol 3 (4) ◽  
pp. 446-448
Author(s):  
Douglas Ader ◽  
Muhammad Durrani ◽  
Eric Blazar
Keyword(s):  
Emergency Department ◽  
Acute Promyelocytic Leukemia ◽  
Disseminated Intravascular Coagulation ◽  
Early Recognition ◽  
Survival Rates ◽  
Purpura Fulminans ◽  
Promyelocytic Leukemia ◽  
Intravascular Coagulation ◽  
Remission Rates

A 47-year-old male presented to the emergency department with 12 hours of nausea, vomiting, abdominal pain, and a widespread skin eruption with mottled, irregular, purpuric lesions with subsequent rapid decompensation. Laboratory analysis revealed thrombocytopenia, bandemia, elevated metamyelocytes, abnormal coagulation panel, decreased fibrinogen, elevated fibrin split products, renal dysfunction, bacterial rods, dohle bodies, and toxic granulation. Acute promyelocytic leukemia (APML) was confirmed via bone marrow biopsy, flow cytometry, and fluorescence in situ hybridization analysis. Disseminated intravascular coagulation (DIC) may be the initial presentation of APML. When treated promptly, APML can achieve high remission rates; however, conditions such as DIC continue to increase mortality requiring early recognition to improve survival rates.

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