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Pogliani报道1例急性早幼粒细胞白血病(APL)患者入院时粘膜出血。Hb 84g/L,WBC 1.1×10~9/L,早幼粒细胞82％,血小板(BPC)17.7×10~9/L,血纤维蛋白原(Fg),<1g/l,D-二聚体160mg/L,抗凝血酶Ⅲ100％,蛋白C 70％,α_2抗纤溶酶40％。骨髓细胞学检查多颗粒早幼粒细胞90％,t(15;17)见于100％中期,PCR证实有PML/RARα重排。全反式维甲酸(ATRA)45mg/m~2(总剂量90mg),d1～25,去甲氧柔红霉素12mg/m~2(总量24mg),i.v.,d2,4,6,8。因出血症状输浓缩血小板。6天内凝血象正常。出血倾向迅速改善,未予抗纤溶药物。第10天突然少尿,血尿素氮(BUN)和肌酐增高。WBC
Pogliani reported mucosal bleeding at the time of admission in one patient with acute promyelocytic leukemia (APL). Hb 84g/L, WBC 1.1×10~9/L, promyelocytic 82%, platelet (BPC) 17.7×10~9/L, fibrinogen (Fg), <1g/l, D-dimer Body 160 mg/L, antithrombin III 100%, protein C 70%, alpha 2 antiplasmin 40%. Bone marrow cytology was used to detect 90% of multigranular promyelocytes, t(15;17) was found in 100% metaphase, and PCR confirmed PML/RARα rearrangement. All-trans retinoic acid (ATRA) 45mg/m~2 (total dose 90mg), d1~25, idarubicin 12mg/m~2 (total amount 24mg),iv,d2,4,6,8 . Infusion of platelet concentrates due to bleeding. Coagulation was normal within 6 days. The bleeding tendency improved rapidly and antifibrinolytic drugs were not given. On the 10th day, she suddenly had little urine, increased blood urea nitrogen (BUN) and creatinine. WBC