Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai Tisch Cancer Institute , New York , NY , USA.
Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai Tisch Cancer Institute , New York , NY , USA.
Leuk Lymphoma. 2019 Oct;60(10):2394-2403. doi: 10.1080/10428194.2019.1581187. Epub 2019 Mar 8.
Fatal hemorrhage is the most common cause of induction failure and death among patients with acute promyelocytic leukemia (APL). However, there remains no established means of hemorrhagic risk stratification in APL. In this single center retrospective study of 43 patients treated for APL group-based trajectory modeling was used to identify laboratory trends associated with major bleeding. Bleeding risk was significantly associated with particular trends in white blood cell count (WBC) and lactate dehydrogenase level (LDH). Specifically, patients who presented with high WBC and/or LDH, and whose WBC and/or LDH then proceeded to uptrend during the initial days of induction, were significantly more likely to experience major bleeding ( = .0111 and = .0143, respectively). Additionally, there appeared to be a temporal association between WBC and LDH trends and major bleeding events. Among nonlaboratory variables, differentiation syndrome (DS) was significantly associated with major bleeding ( = .00149).
致命性出血是急性早幼粒细胞白血病（APL）患者诱导失败和死亡的最常见原因。然而，APL 中仍然没有明确的出血风险分层方法。在这项针对 43 名 APL 患者的单中心回顾性研究中，采用基于群组的轨迹建模来确定与大出血相关的实验室趋势。出血风险与白细胞计数（WBC）和乳酸脱氢酶水平（LDH）的特定趋势显著相关。具体而言，WBC 和/或 LDH 较高且诱导初期 WBC 和/或 LDH 呈上升趋势的患者，发生大出血的可能性显著更高（ = .0111 和 = .0143，分别）。此外，WBC 和 LDH 趋势与大出血事件之间似乎存在时间关联。在非实验室变量中，分化综合征（DS）与大出血显著相关（ = .00149）。
