Four patients with acute promyelocytic leukemia manifested multiple coagulation abnormalities including hypofibrinogenemia, prolongation of prothrombin and thrombin times, and varying deficiencies of coagulation factors. One of the patients (patient 2) showed rising levels of fibrinogen without changes in other coagulation factors on heparin therapy and demonstrated widespread intravascular coagulation on postmortem examination. Another patient (patient 1) had positive tests for active fibrinolysis and an absolute lack of the usual postmortem thrombi. The current hypotheses of the pathogenesis of the coagulation abnormalities are presented as well as guide to therapeutic management.
Rand JJ, Moloney WC, Sise HS. Coagulation Defects in Acute Promyelocytic Leukemia. Arch Intern Med. 1969;123(1):39-47. doi:10.1001/archinte.1969.00300110041007