A 15-year-old boy presented with one day history of bleeding gums, subconjunctival bleed and purpuric rash. Investigations revealed the following results: Hb-6.4 gm/dL; TLC-26,500/mm3 Platelet 35,000 mm3; prothrombin time-20 sec with a control of 13 sec; paial thromboplastin time-50 sec; and Fibrinogen 10mg/dL. Peripheral smear was suggestive of acute myeloblastic leukemia. Which of the following is the most likely?
The child presented with acute onset of bleeding, along with the following laboratory findings: Thrombocytopenia (35000/mm3 as compared to normal value of 1, 50,000/mm3) Increased prothrombin time (20s as compared to control of 13s) Increased paial thromboplastin time (50s vs. normal 26-32s) Decreased fibrinogen (10 mg/dL vs. normal of 233- 496 mg/dl) These hematological abnormalities indicate disseminated intravascular coagulation. Most common form of AML associated with DIC is M3-AML (Acute promyelocytic leukemia). All-trans retinoic acid (ATRA), an analogue of vitamin A induce the neoplastic promyelocytes to differentiate into neutrophils rapidly and decrease chance of DIC. other agent useful is AsO3(arsenic trioxide).