Seven adults with acute promyelocytic leukemia (APL) and disseminated intravascular coagulation were treated for remission induction with daunorubicin hydrochloride and prednisone. In all patients the coagulopathy was managed with continuous-infusion heparin sodium and vigorous transfusion with platelets, cryoprecipitate, and fresh frozen plasma. Five patients survived induction; they all achieved complete remission (CR). Median duration of CR was 27+ months; two patients presently survive in their initial CR at 28 and 48 months. Recognition of APL as a distinct type of acute leukemia and prompt initiation of treatment aimed at rapid cytoreduction and control of the coagulopathy has resulted in a prolonged disease-free survival for the majority of patients.
(Arch Internal Med 138:1677-1680, 1978)
Collins AJ, Bloomfield CD, Peterson BA, McKenna RW, Edson JR. Acute Promyelocytic Leukemia: Management of the Coagulopathy During Daunorubicin-Prednisone Remission Induction. Arch Intern Med. 1978;138(11):1677–1680. doi:10.1001/archinte.1978.03630360059024
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