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- Title
Disseminated intravascular coagulation score evolution in 48 h predicts early death in acute promyelocytic leukemia patients.
- Authors
Infante, Joana Brioso; Esteves, Graça Vasconcelos; Raposo, João; de Lacerda, João Forjaz
- Abstract
Introduction: Early death (ED) is the unsolved issue of acute promyelocytic leukemia (APL). The disseminated intravascular coagulation (DIC) score has been proposed as a marker of bleeding and death in APL; whether its temporal evolution predicts outcomes in APL is unknown. We evaluated whether an increasing score 48 h after diagnosis associates with ED. Methods: Retrospective, single‐center study, including patients with newly diagnosed APL between 2000 and 2023, treated with all‐transretinoic acid (ATRA) plus anthracycline or arsenic trioxide (ATO). "DIC score worsening" was defined as ≥1 point increase in the score after 48 h, and ED as death within 30 days of diagnosis. Results: Eighty‐six patients were included, with median age of 46 years (17–82). ED patients (26.7%) more frequently had age >60 years and worsening DIC score after 48 h. These were also the only predictors of ED identified in both univariate and multivariate (OR 4.18, p =.011; OR 7.8, p =.005, respectively) logistic regression analysis. Conclusion: This is the first study on DIC score evolution in APL—a worsening DIC score 48 h after diagnosis is a strong independent predictive factor of ED. We propose a reduction of the DIC score from diagnosis as a new treatment goal in APL care.
- Subjects
ACUTE promyelocytic leukemia; DISSEMINATED intravascular coagulation; EARLY death; LOGISTIC regression analysis
- Publication
European Journal of Haematology, 2024, Vol 112, Issue 5, p840
- ISSN
0902-4441
- Publication type
Article
- DOI
10.1111/ejh.14177