A 65-year-old woman referred to the emergency department for fever and alterations in the laboratory tests: hemoglobin 11.4 g/dL, leukocytes 0.86 x103/μL,(neutrophils 41.9%, lymphocytes 55.8%),platelets 48.0 x103/μL, fibrinogen 118 mg/dL,D-dimer 20.2 μg/mL. Bone marrow examination was performed and she was diagnosed with acute leukemia with t(15;17) in 60% of the cells. Which of the following answers is correct?
It is a definitive promyelocytic leukemia with t(15;17), and as it is well known by all of you the treatment is with arsenic trioxide + ATRA. Option 1 leaves the treatment incomplete, there is only ATRA and it must be treated as long as the patient's condition allows it, whether or not there are symptoms. Option 3 3 years ago would have been the correct option but nowadays neither chemotherapy nor heparin is used. And option 4 is false because that fever is due to the leukemia itself and the priority is to start specific treatment for leukemia.
If asymptomatic, transretinoic acid (ATRA) will be started and day hospital controls will be recommended.
Start treatment with arsenic trioxide, ATRA and supportive therapy.
It is a myeloblastic leukemia type M3, so chemotherapy and heparin will be started to control disseminated intravascular coagulation.
Antibiotic treatment should be started. When the fever disappears, leukemia treatment should be started.
Option 1 leaves the treatment incomplete, there is only ATRA and it must be treated as long as the patient's condition allows it, whether or not there are symptoms.
It is a definitive promyelocytic leukemia with t(15;17), and as it is well known by all of you the treatment is with arsenic trioxide + ATRA.
Option 3 3 years ago would have been the correct option but nowadays neither chemotherapy nor heparin is used.
option 4 is false because that fever is due to the leukemia itself and the priority is to start specific treatment for leukemia.