Q: Acute promyelocytic leukemia (APL) is a medical emergency because? 

A) Life-threatening hemorrhagic coagulopathy 
B) High risk of massive Pulmonary Embolism
C) Cardiogenic shock
D) Neutropenic fever, sepsis and death
E) Massive stroke


Answer: A

Acute promyelocytic leukemia (APL) is a medical emergency due to its characteristic coagulopathy, causing fatal hemorrhage. Though aggressive transfusions of platelets and cryoprecipitate may help but mainstay of treatment is initiation of treatment with all-trans retinoic acid (ATRA) ASAP even though definitive confirmation of the diagnosis is not  made.


Reference: 

1. Park JH, Qiao B, Panageas KS, et al. Early death rate in acute promyelocytic leukemia remains high despite all-trans retinoic acid. Blood 2011; 118:1248.