Treatment Analysis of a Patient with Acute Promyelocytic Leukemia Complicated by Disseminated Intravascular Coagulation

YANG Jianzhong; WU Hualing; CHEN Qi; LUO Ying

doi:10.13919/j.issn.2095-6274.ZHJY202511003

Abstract：Objective To analyze the clinical features,diagnosis,and treatment of acute promyelocytic leukemia(APL)complicated by disseminated intravascular coagulation(DIC),and to provide a reference for the diagnosis and treat-ment of similar clinical cases.Methods A retrospective analysis was conducted on a 34-year-old female patient admit-ted to the Department of Hematology,Quanzhou First Hospital,Fujian Province,in 2024.The patient was diagnosed with APL complicated by DIC and stratified as intermediate-risk based on complete blood count,coagulation function,bone marrow morphology,and flow cytometry.Treatment included blood products to correct DIC.Upon high suspicion of APL,all-trans retinoic acid induction therapy was initiated immediately.After confirmation of the diagnosis,arsenious acid was added to form a dual induction regimen.Piperacillin-tazobactam was administered for infection control,alongside simul-taneous DIC management and supportive care.Regular monitoring of complete blood count,coagulation function,bone marrow morphology,and the PML-RARα gene was performed.Results The patient's coagulation function returned to normal 10 days after admission,and complete remission was achieved within one month.During the one-year follow-up period,the patient's PML-RARα fusion gene remained continuously negative,complete blood count and coagulation function were normal,with no signs of disease recurrence.Conclusion Pancytopenia and coagulation abnormalities are important indicators for diagnosing APL complicated by DIC.Prompt treatment with all-trans retinoic acid combined with arsenious acid,along with active correction of coagulation function,infection control,and implementation of supportive care,can contribute to achieving sustained remission.