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
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.
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.