Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
Department of Translational and Precision Medicine, University 'La Sapienza' of Rome, Rome, Italy.
Br J Haematol. 2021 Apr;193(1):129-132. doi: 10.1111/bjh.17018. Epub 2020 Aug 10.
Acute promyelocytic leukaemia (APL) represents a modern success of precision medicine. However, fatalities occurring within the first 30 days of induction treatment, in particular intracranial haemorrhage (ICH), remain the main causes of death. We studied the clinico-biological characteristics of 13 patients with APL who experienced ICH. Compared to 85 patients without this complication, patients with ICH were older and more frequently had high-risk APL. Moreover, positivity for the 'swirl' sign at neuroradiological imaging and hydrocephalus were predictors of a fatal outcome, together with lower fibrinogen, prolonged international normalized ratio (INR) and higher lactate dehydrogenase levels.
急性早幼粒细胞白血病 (APL) 是精准医学的现代成功范例。然而，诱导治疗的前 30 天内发生的死亡，特别是颅内出血 (ICH)，仍然是主要的死亡原因。我们研究了 13 例发生 ICH 的 APL 患者的临床生物学特征。与 85 例无此并发症的患者相比，ICH 患者年龄更大，且更常患有高危 APL。此外，神经影像学上的“漩涡”征阳性和脑积水是致命结局的预测因素，同时还伴有纤维蛋白原降低、国际标准化比值 (INR) 延长和乳酸脱氢酶水平升高。
