Administration of ATRA to newly diagnosed patients with acute promyelocytic leukemia is delayed contributing to early hemorrhagic death

Leuk Res. 2013 Sep;37(9):1004-9. doi: 10.1016/j.leukres.2013.05.007. Epub 2013 Jun 14.

Abstract

We hypothesized that the high early death rate (EDR) due to bleeding in acute promyelocytic leukemia (APL) is in part attributable to delays in all- trans retinoic acid (ATRA). We conducted a retrospective analysis of the timing of ATRA administration. 204 consecutive patients with newly diagnosed APL between 1992 and 2009 were identified. The EDR was 11%. 44% of early deaths occurred in the first week. Hemorrhage accounted for 61% of early deaths. ATRA was ordered the day APL was suspected in 31% of patients. Delays in ATRA administration led to increases in the percentage of early deaths from hemorrhage.

Keywords: ATRA; Acute Promyelocytic Leukemia; Early Death Rate; Hemorrhage.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / adverse effects*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Hemorrhage / chemically induced
  • Hemorrhage / mortality*
  • Humans
  • Leukemia, Promyelocytic, Acute / complications*
  • Leukemia, Promyelocytic, Acute / drug therapy
  • Leukemia, Promyelocytic, Acute / mortality
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Tretinoin / adverse effects*
  • Young Adult

Substances

  • Antineoplastic Agents
  • Tretinoin