The Internet Book of Critical Care Podcast
IBCC Episode 69 - Acute Promyelocytic Leukemia
Dec 19, 2019
This podcast episode covers acute promyelocytic leukemia, including its pathophysiology, clinical presentation, and diagnostic clues. It also discusses the importance of recognizing DIC associated with APL and highlights the potential complications of differentiation syndrome. The management approach for APL patients, including the use of blood products and potential use of tranexamic acid, is explored. The podcast also touches on prophylaxis, clinical features, and the mainstay of supportive care in ICU for APL.
17:47
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Quick takeaways
- Recognition of acute promyelocytic leukemia (APL) is crucial as delayed treatment can result in fatal bleeding.
- Initiating all trans-retinoic acid (ATRA) early in APL patients is essential, but complications like differentiation syndrome can still occur.
Deep dives
Pathophysiology of acute pro-mylocytic leukemia
Acute pro-mylocytic leukemia (APL) occurs when there is a translocation of chromosomes, resulting in the fusion of PML and a rare gene, preventing myelocytes from differentiating into myocytes. This causes the pro-mylocytes to become immortal and lead to malignancy. Treatment with all trans-retinocacid allows the cells to differentiate, curing the leukemia but causing a potential differentiation syndrome and cytokine storm.
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