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

Jessica K. Altman, Alfred Rademaker, Elizabeth Cull, Bing Bing Weitner, Yishai Ofran, Todd L. Rosenblat, Augustin Haidau, Jae H. Park, Sharona Lee Ram, James M. Orsini, Sonia Sandhu, Rosalind Catchatourian, Steven M. Trifilio, Nelly G. Adel, Olga Frankfurt, Eytan M. Stein, George Mallios, Tony Deblasio, Joseph G. Jurcic, Stephen NimerLo Ann C. Peterson, Hau C. Kwaan, Jacob M. Rowe, Dan Douer, Martin S. Tallman

Research output: Contribution to journalArticle

51 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1004-1009
Number of pages6
JournalLeukemia Research
Volume37
Issue number9
DOIs
StatePublished - Sep 1 2013

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Keywords

  • Acute Promyelocytic Leukemia
  • ATRA
  • Early Death Rate
  • Hemorrhage

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology

Cite this

Altman, J. K., Rademaker, A., Cull, E., Weitner, B. B., Ofran, Y., Rosenblat, T. L., Haidau, A., Park, J. H., Ram, S. L., Orsini, J. M., Sandhu, S., Catchatourian, R., Trifilio, S. M., Adel, N. G., Frankfurt, O., Stein, E. M., Mallios, G., Deblasio, T., Jurcic, J. G., ... Tallman, M. S. (2013). Administration of ATRA to newly diagnosed patients with acute promyelocytic leukemia is delayed contributing to early hemorrhagic death. Leukemia Research, 37(9), 1004-1009. https://doi.org/10.1016/j.leukres.2013.05.007