Dynamic observation of the effect on coagulation function of arsenic trioxide in children with acute promyelocytic leukemia / 国际儿科学杂志

ABSTRACT

Objective:Patients with acute promyelocytic leukemia(APL)treated with arsenic trioxide(ATO)have significant coagulation disorders both in pretherapy and post-treatment, and severe cases can progress quickly to the disseminated intravascular coagulation(DIC). This article aims to investigate the risk factors of DIC and observe dynamically the effect of ATO on coagulation function in APL children.Methods:We collected basic characteristics, laboratory characteristics and coagulation index at various time points on admission of 28 children who were first diagnosed APL and treated with ATO at department of pediatric hematology in Shengjing Hospital from January 2012 to January 2018. We retrospectively analyzed the correlation between these factors and the occurrence of DIC, and the trend of dynamic changes in coagulation index in different treatment time.Results:Of the 28 patients, 24(85.7%)were diagnosed as DIC. No relation has been found between the occurrence of DIC and the age, gender, blood routine at initial diagnosis, fibrinogen level, lactate dehydrogenase level in APL children( P>0.05). Different indicators of plasma prothrombin time, fibrinogen at different time point showed significantly difference. In the high-risk group, PT was higher significantly before treatment[(17.58±2.99)s] than those of the 3-4 days after therapy[(15.3±1.86)s], 7-10 days after therapy[(13.81±1.18)s], 14-16 days after therapy[(14.13±0.62)s], 22-26 days after therapy[(14.2±1.59)s]( P=0.016). In the group which PLT was greater than or equal to 20×10 9/L, PT was higher significantly before treatment[(15.02±2.83)s]and the 3-4 days after therapy[(14.59±2.19)s] than those of the 7-10 days after therapy[(13.25±2.01)s], 14-16 days after therapy[(13.31±1.51)s], 22-26 days after therapy[(13.47±1.64)s]( P<0.01). Conclusion:No relation has been found between the occurrence of DIC and the age, gender, blood routine at initial diagnosis, fibrinogen level, lactate dehydrogenase level in APL children. The time points of significantly abnormal of coagulation function occurred in the newly diagnosed APL children were before the ATO induction treatment and the 3-4 days after therapy.