Life-threatening bleeding, which remains a challenging complication of acute leukaemia, is particularly characteristic of the subtype, acute promyelocytic leukaemia (APL). The clinical picture and laboratory abnormalities are most compatible with the diagnosis of disseminated intravascular coagulation (DIC). Evidence for diffuse activation of the coagulation system, hyperfibrinolysis and systemic elaboration of non-specific protease activity can usually be demonstrated and occurs most commonly during induction chaemotherapy. While both host- and tumour-associated mechanisms can be implicated in the pathogenesis of the coagulopathy, leukaemic cell properties appear to be the proximate cause of activation of the haemostatic mechanisms. In this chapter we summarize the current state of knowledge of the pathogenesis of the coagulopathy of APL and the therapeutic approaches that have proved most useful for the management of this complication. Special attention is devoted to the use of all-traps-retinoic acid (ATRA), which has revolutionized the treatment of APL and markedly ameliorated the APL-related coagulopathy.

Falanga, A., Rickles, F. (2003). Pathogenesis and management of the bleeding diathesis in acute promyelocytic leukaemia. BAILLIERE'S BEST PRACTICE IN CLINICAL HAEMATOLOGY, 16(3), 463-482 [10.1053/ybeha.2003.270].

Pathogenesis and management of the bleeding diathesis in acute promyelocytic leukaemia

Falanga A
;
2003

Abstract

Life-threatening bleeding, which remains a challenging complication of acute leukaemia, is particularly characteristic of the subtype, acute promyelocytic leukaemia (APL). The clinical picture and laboratory abnormalities are most compatible with the diagnosis of disseminated intravascular coagulation (DIC). Evidence for diffuse activation of the coagulation system, hyperfibrinolysis and systemic elaboration of non-specific protease activity can usually be demonstrated and occurs most commonly during induction chaemotherapy. While both host- and tumour-associated mechanisms can be implicated in the pathogenesis of the coagulopathy, leukaemic cell properties appear to be the proximate cause of activation of the haemostatic mechanisms. In this chapter we summarize the current state of knowledge of the pathogenesis of the coagulopathy of APL and the therapeutic approaches that have proved most useful for the management of this complication. Special attention is devoted to the use of all-traps-retinoic acid (ATRA), which has revolutionized the treatment of APL and markedly ameliorated the APL-related coagulopathy.
Articolo in rivista - Articolo scientifico
APL, tumour, bleeding, coagulopathy
English
463
482
20
Falanga, A., Rickles, F. (2003). Pathogenesis and management of the bleeding diathesis in acute promyelocytic leukaemia. BAILLIERE'S BEST PRACTICE IN CLINICAL HAEMATOLOGY, 16(3), 463-482 [10.1053/ybeha.2003.270].
Falanga, A; Rickles, F
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/280981
Citazioni
  • Scopus 71
  • ???jsp.display-item.citation.isi??? 59
Social impact