Massive pulmonary embolism at the onset of acute promyelocytic leukemia

Federica Sorà, Patrizia Chiusolo, Luca Laurenti
  • Patrizia Chiusolo
    , Luca Laurenti, Francesco Autore, Sabrina Giammarco and Simona Sica,
  • Luca Laurenti
    Affiliation not present


Life-threatening bleeding is a major and early complication of acute promyelocytic leukemia (APL), but in the last years there is a growing evidence of thromboses in  APL. We report the first case of a young woman with dyspnea as the first symptom of APL due to massive pulmonary embolism (PE) successfully treated with thrombolysis for PE and heparin. APL has been processed with a combination of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) obtaining complete remission.


acute promyelocytic leukemia , pulmonary embolism, thrombolysis, arsenic trioxide.

Full Text:

Submitted: 2016-03-02 14:13:01
Published: 2016-07-01 00:00:00
Search for citations in Google Scholar
Related articles: Google Scholar


Rashidi A, Silverberg ML, Conkling PR, Fisher SI. Thrombosis in acute promyelocytic leukemia.Thromb Res. 2013;131:281-9.

Choudhry, T.G. DeLoughery.Bleeding and thrombosis in acute promyelocytic leukemia. Am J Hematol, 2012;87, 596–603

Lo-Coco F1, Avvisati G, Vignetti M, et al Gruppo Italiano Malattie Ematologiche dell'Adulto; German-Austrian Acute Myeloid Leukemia Study Group; Study Alliance Leukemia.Retinoic acid and arsenic trioxide for acute promyelocytic leukemia. N Engl J Med. 2013;369:111-21.

Mitrovic M1, Suvajdzic N, Bogdanovic A et al.International Society of Thrombosis and Hemostasis Scoring System for disseminated intravascular coagulation ≥ 6: a new predictor of hemorrhagic early death in acute promyelocytic leukemia. Med Oncol. 2013;30:478.

Guyatt GH, Akl EA, Crowther M, Gutterman DD, Schunemann HJ for the American College of Chest Physicians Antithrombotic Therapy and Prevention of Thrombosis Panel. Executive Summary: Antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141:7S-47S

Sanz MA1, Montesinos P.How we prevent and treat differentiation syndrome in patients with acute promyelocytic leukemia. Blood2014 May 1;123:2777-82

De Stefano V, Sorà F, Rossi E et al.The risk of thrombosis in patients with acute leukemia: occurrence of thrombosis at diagnosis and during treatment. J Thromb Haemost. 2005 ;3:1985-92.

Lo-Coco F, Avvisati G, Vignetti M, et al; Italian GIMEMA Cooperative Group. Front-line treatment of acute promyelocytic leukemia with AIDA induction followed by risk-adapted consolidation for adults younger than 61 years: results of the AIDA-2000 trial of the GIMEMA Group.Blood. 2010 ;116:3171-9.

Breccia M, Avvisati G, Latagliata R et al Occurrence of thrombotic events in acute promyelocytic leukemia correlates with consistent immunophenotypic and molecular features.Leukemia. 2007 ;21:79-83

Mitrovic M, Suvajdzic N, Elezovic I, et al.Thrombotic events in acute promyelocytic leukemia. Thromb Res. 2015;4:588-93.

Vaid AK, Batra S, Karanth SS, Gupta S. Acute promyelocytic leukemia presenting as pulmonary thromboembolism: Not all APLs bleed. Avicenna J Med. 2015;5:131-3.

Abstract views:


Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM

Comments on this article

View all comments

Copyright (c) 2016 Mediterranean Journal of Hematology and Infectious Diseases

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
© PAGEPress 2008-2018     -     PAGEPress is a registered trademark property of PAGEPress srl, Italy.     -     VAT: IT02125780185     •     Privacy