The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Analysis of factors affecting hemorrhagic diathesis and overall survival in patients with acute promyelocytic leukemia

  • Lee, Ho Jin (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Kim, Dong Hyun (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Lee, Seul (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Koh, Myeong Seok (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Kim, So Yeon (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Lee, Ji Hyun (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Lee, Suee (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Oh, Sung Yong (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Han, Jin Yeong (Department of Laboratory Medicine, Dong-A University College of Medicine) ;
  • Kim, Hyo-Jin (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Kim, Sung-Hyun (Department of Internal Medicine, Dong-A University College of Medicine)
  • Received : 2013.07.26
  • Accepted : 2014.10.31
  • Published : 2015.11.01
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Abstract

Background/Aims: This study investigated whether patients with acute promyelocytic leukemia (APL) truly fulfill the diagnostic criteria of overt disseminated intravascular coagulation (DIC), as proposed by the International Society on Thrombosis and Haemostasis (ISTH) and the Korean Society on Thrombosis and Hemostasis (KSTH), and analyzed which component of the criteria most contributes to bleeding diathesis. Methods: A single-center retrospective analysis was conducted on newly diagnosed APL patients between January 1995 and May 2012. Results: A total of 46 newly diagnosed APL patients were analyzed. Of these, 27 patients (58.7%) showed initial bleeding. The median number of points per patient fulfilling the diagnostic criteria of overt DIC by the ISTH and the KSTH was 5 (range, 1 to 7) and 3 (range, 1 to 4), respectively. At diagnosis of APL, 22 patients (47.8%) fulfilled the overt DIC diagnostic criteria by either the ISTH or KSTH. In multivariate analysis of the ISTH or KSTH diagnostic criteria for overt DIC, the initial fibrinogen level was the only statistically significant factor associated with initial bleeding (p = 0.035), but it was not associated with overall survival (OS). Conclusions: Initial fibrinogen level is associated with initial presentation of bleeding of APL patients, but does not affect OS.

Keywords

Acknowledgement

Supported by : Dong-A University

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