Abstract
Despite enormous improvement in the management of patients with acute promyelocytic
leukemia (APL), the distinctive coagulopathy observed at presentation in affected
patients is often life-threatening. While hemorrhagic manifestations are well known
and described in this setting, APL-related thromboses are underappreciated. Data regarding
this complication are scarce showing variable incidence. Furthermore, risk factors
for thrombosis are inconsistent and unreliable; so, differentiation of increased risk
of hemorrhage from an increased thrombotic risk is quite difficult in the absence
of adequate predictive scores. Besides, prophylactic use of anticoagulants and recombinant
thrombomodulin are a matter of ongoing debate. Also, due to the common feature of
thrombocytopenia and other hemorrhagic risks, patients with APL are excluded from
trials analyzing anticoagulant prophylaxis in cancers; so, data from prospective trials
are lacking. A detailed analysis of thrombotic risks in APL with the development of
a reliable risk stratification model is needed to further improve the care of APL
patients.
Keywords
acute promyelocytic leukemia - thrombosis - hypercoagulability
