Case 114 – Update3!

Thanks for everyones contributions to our case so far! We now have confirmation of our suspected diagnosis of Acute Promyelocytic Leukaemia by FISH. We have already began discussing initial management. Following the suggestions to date we have instituted the following:

  • ATRA treatment. With monitoring for differentiation syndrome. We have not started prophylactic dexamethasone as WCC 3.6 when ATRA started.
  • Intensive blood product support

There is some debate from responses of what definitive treatment to commence between arsenic, chemotherapy or combination of arsenic and chemotherapy.

Questions:

  1. How do we risk stratify patients with APL? How does this influence our treatment decision?
  2. What other factors/investigations would you consider/perform prior to commencing your chosen treatment?

 

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