Clinical Features and Gene Mutations of Disseminated Intravascular Coagulation Patients in Acute Promyelocytic Leukemia

Gao L, Li H, Guo Y, Li X, Yao H, Wu D, Chen S, Pu J, Ruan C

Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, China
Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, China
Department of Clinical Laboratory, Pingdingshan Branch of The 989th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, China
Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, China,
The Center of Health Management, The First Affiliated Hospital of Soochow University, China
These authors contributed equally to this work

^*Correspondance to: Changgeng Ruan 

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Abstract:

Acute Promyelocytic Leukemia (APL) is a special type of Acute Myeloid Leukemia (AML). Disseminated Intravascular Coagulation (DIC) is a common but life-threatening complication of APL patients, however, the significances of clinical features and gene mutations between DIC and non DIC patients in APL is not well-established. We retrospectively analyzed 73 newly diagnosed
APL patients with and without DIC. Of the 73 patients included, there were 28 (38.4%) DIC patients. DIC patients in APL had higher White Blood Cell (WBC) counts (p<0.001), higher ECOG performance status (p=0.021), higher risk degree (p<0.001) and higher Lactate Dehydrogenase (LDH) (p=0.012). What’s more, DIC patients were associated with higher incidences of Earth Death (ED) (p=0.009) and hemorrhage (p=0.004). The genetic mutation profiling of DIC patients showed a higher FLT3-ITD mutation (p=0.038). Most importantly, DIC patients showed a faster decline of PML-RARα mRNA during induction therapy (P=0.019). Our study may provide a new perspective to understand the prediction and treatment of DIC patients in APL.

Keywords:

Acute promyelocytic leukemia; Disseminated intravascular coagulation; Clinical features; FLT3-ITD mutation

Cite the Article:

Gao L, Li H, Guo Y, Li X, Yao H, Wu D, et al. Clinical Features and Gene Mutations of Disseminated Intravascular Coagulation Patients in Acute Promyelocytic Leukemia. Clin Oncol. 2023;8:1998..