Thrombotic events in acute promyelocytic leukemia. Issue 4 (April 2015)

• Record Type: Journal Article
• Authors: Mitrovic, Mirjana; Suvajdzic, Nada; Elezovic, Ivo; Bogdanovic, Andrija; Djordjevic, Valentina; Miljic, Predrag; Djunic, Irena; Gvozdenov, Maja; Colovic, Natasa; Virijevic, Marijana; Lekovic, Danijela; Vidovic, Ana; Tomin, Dragica
• Is Part Of: Thrombosis research. Volume 135:Issue 4(2015)
• Page Start: 588
• Page End: 593
• Publication Date: 2015-04
• Subjects: Thrombosis -- Periodicals; 616.135
• DOI: 10.1016/j.thromres.2014.11.026
• Languages: English
• ISSNs: 0049-3848

Abstract

<abstract abstract-type="author" id="ab0005"> <title id="st0005">Abstract</title> <sec> <title id="st0010">Introduction</title> <p id="sp0005">Thrombotic events (TE) appear to be more common in acute promyelocytic leukemia (APL) than in other acute leukemias, with reported prevalence ranging from 2 to10-15%.</p> </sec> <sec> <title id="st0015">Materials and Methods</title> <p id="sp0010">We retrospectively analyzed the data on TE appearance in 63 APL patients.</p> </sec> <sec> <title id="st0020">Results</title> <p id="sp0015">TE occured in 13 (20.6%) cases, four arterial (6.3%) and nine venous (14.3%). TE were more frequently diagnosed after initiation of weekly D-dimer monitoring (7 TE during 20 months vs 6 during 76 months, <italic>P = 0.032</italic>). Patients with and without venous thrombosis were significantly different regarding female/male ratio (<italic>P = 0.046</italic>), PT (<italic>P = 0.022</italic>), aPTT (<italic>P = 0.044</italic>), ISTH DIC score (<italic>P = 0.001</italic>), bcr3 (<italic>P = 0.02</italic>) and <italic>FLT3-ITD</italic> (<italic>P = 0.028</italic>) mutation. The most significant risk factor for venous TE occurrence in multivariate analysis was <italic>FLT3-ITD</italic> mutation (<italic>P = 0.034</italic>). PAI-1 4G/4G polymorphism was five times more frequent in patients with venous TE than without it (<italic>P = 0.05</italic>). Regarding risk factors for arterial TE we failed to identify any.</p> </sec> <sec> <title id="st0025">Conclusions</title> <p id="sp0020">We have demonstrated that APL-related TE rate is higher than previously reported and that weekly D-dimer monitoring might help to identify patients with silent thrombosis. Moreover, our study suggests a possible relationship between venous TE occurrence and several laboratory findings (PT, aPTT, ISTH DIC score, bcr3 isoform, <italic>FLT3-ITD</italic> mutation and PAI 4G/4G). Prophylactic use of heparin might be considered in patients with ISTH DIC score < 5, bcr3 isoform, <italic>FLT3-ITD</italic> mutation and PAI 4G/4G.</p> </sec> </abstract>