What are the possible complications of acute promyelocytic leukemia (APL)?

Updated: May 03, 2019
  • Author: Sandy D Kotiah, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

The most important complications of acute promyelocytic leukemia (APL) are bleeding diathesis secondary to underlying coagulopathy (5%), infection (2.3%), and differentiation syndrome (1.4%). [28] The coagulopathy should be monitored closely to prevent early mortality. Infection can occur at any time and should be treated promptly with antibiotics. Patients with differentiation syndrome should be treated with intravenous steroids to prevent treatment-related mortality.

ATRA helps to rapidly control the disseminated intravascular coagulation (DIC) associated with APL. It is important to note that the treatment of disseminated intravascular coagulation (DIC) should also include platelet transfusions to maintain the platelet count at about 20,000/μL and cryoprecipitate to maintain a fibrinogen level at least above 100-150 mg/dL. [14, 10]


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