Carella Angelo M, Antonucci Giuseppe, Conte Matteo, Di Pumpo Michele, Antonucci Elisabetta, Ponziano Ernestina
Internal Medicine Department of T. Masselli-Mascia Hospital - San Severo (Fg), Italy.
Cardiovasc Hematol Disord Drug Targets. 2010 Mar;10(1):1-6. doi: 10.2174/187152910790780069.
Acute promyelocytic leukemia (APL) is frequently associated, often from the earliest phases, with a life-threatening coagulation/bleeding syndrome; disseminated intravascular coagulation (DIC) is described in majority of patients. We report a case of 49-year-old male, without cardiovascular risk factors, who suddenly developed ischemic stroke and splenic infarction as presenting symptoms of APL and related DIC. The patient was immediately treated with all-trans retinoic acid (ATRA) and the alterations of hemocoagulation parameters promptly returned in normal range. The coagulation/bleeding syndrome of the onset of APL is associated with high mortality; both diagnostic and therapeutic approaches require special and timely consideration of this condition. Treatment with ATRA is essential.
急性早幼粒细胞白血病（APL）常常从疾病最早期就与一种危及生命的凝血/出血综合征相关联；大多数患者会出现弥散性血管内凝血（DIC）。我们报告一例49岁男性患者，无心血管危险因素，其突然发生缺血性中风和脾梗死，作为APL及相关DIC的首发症状。患者立即接受全反式维甲酸（ATRA）治疗，血液凝固参数的改变迅速恢复到正常范围。APL发病时的凝血/出血综合征与高死亡率相关；诊断和治疗方法都需要对这种情况进行特殊且及时的考虑。使用ATRA治疗至关重要。
