medicnotes.org.uk :: Acute promyelocytic leukaemia

Acute promyelocytic leukaemia (APML)

Is a subtype of AML (M3 subtype)

Clinical features:

Has a specific association with disseminated intravascular coagulation (DIC)
Patients may present with severe bleeding which worsens when treatment is started as the leukaemic blast cells break down, leading to further consumption of clotting factors and platelets

Treatment:

Regular, twice daily platelet transfusion and maintenance of the fibrinogen level with FFP as the chemotherapy is given
Provided that remission can be achieved, patients with APML have a better overall prognosis than patients with other subtypes of AML
Oral ATRA (all-trans-retinoic acid) can lead to achievement of CR in most patients with APML
Unfortunately, these remissions are not durable and, therefore, they must be consolidated with conventional chemotherapy


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	Acute promyelocytic leukaemia (APML) Is a subtype of AML (M3 subtype) Clinical features: Has a specific association with disseminated intravascular coagulation (DIC) Patients may present with severe bleeding which worsens when treatment is started as the leukaemic blast cells break down, leading to further consumption of clotting factors and platelets Treatment: Regular, twice daily platelet transfusion and maintenance of the fibrinogen level with FFP as the chemotherapy is given Provided that remission can be achieved, patients with APML have a better overall prognosis than patients with other subtypes of AML Oral ATRA (all-trans-retinoic acid) can lead to achievement of CR in most patients with APML Unfortunately, these remissions are not durable and, therefore, they must be consolidated with conventional chemotherapy
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