Gmür J, Gürtler J, Straub P W
Schweiz Med Wochenschr. 1976 Feb 14;106(7):205-9.
A complete remission of 5-16 months' duration was achieved in 5 of 6 consecutive patients with acute promyelocytic leukemia treated with Daunomycin and platelet transfusions. Although 4 patients had coagulation findings suggesting disseminated intravascular coagulation, heparin was given in only one case. Heparin infusion was twice accompanied by normalization of the fibrinogen level, but had to be stopped because of severe bleeding. In the other 5 patients chemotherapy was not accompanied by increased bleeding, although 1 patient showed an initial worsening of the coagulation findings. Platelet substitution and intensive chemotherapy appear to play a more crucial role than theoretically questionalbe treatment of the plasmatic coagulation disturbance. 2 patients had central nervous system involvement, a complication previously thought to be extremely rare in acute promyelocytic leukemia.
连续6例接受柔红霉素和血小板输注治疗的急性早幼粒细胞白血病患者中有5例实现了持续5至16个月的完全缓解。尽管4例患者的凝血检查结果提示弥散性血管内凝血,但仅1例给予了肝素治疗。肝素输注两次伴随着纤维蛋白原水平恢复正常,但因严重出血而不得不停药。在其他5例患者中,化疗并未伴随出血增加,尽管1例患者最初凝血检查结果有所恶化。血小板替代和强化化疗似乎比理论上有疑问的血浆凝血障碍治疗发挥着更关键的作用。2例患者有中枢神经系统受累,这是一种以前认为在急性早幼粒细胞白血病中极为罕见的并发症。