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


MeSH Major

  • Antineoplastic Agents
  • Hemorrhage
  • Leukemia, Promyelocytic, Acute
  • Tretinoin


  • 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.

publication date

  • September 2013



  • Academic Article



  • eng

Digital Object Identifier (DOI)

  • 10.1016/j.leukres.2013.05.007

PubMed ID

  • 23768930

Additional Document Info

start page

  • 1004

end page

  • 9


  • 37


  • 9