What is a significant risk associated with Acute Promyelocytic Leukemia (APL)?

Acute Promyelocytic Leukemia (APL) is associated with a unique risk of disseminated intravascular coagulation (DIC), primarily due to the presence of promyelocytes that release pro-coagulant factors. These promyelocytes can also contain bundles of fibrin, known as "faggot cells," which can lead to an increased consumption of clotting factors and platelets, resulting in DIC.

DIC is a serious and potentially life-threatening condition characterized by widespread clot formation in small blood vessels, followed by bleeding due to the exhaustion of clotting factors and platelets. In patients with APL, the risk of DIC is particularly high at diagnosis and requires immediate medical intervention to manage the bleeding complications and initiate appropriate treatment for the leukemia.

While infection, hemorrhage, and anemia are also seen in patients with APL due to bone marrow failure and cytopenias, the most distinctive and significant risk that sets APL apart, especially when considering its clinical presentation, is the development of DIC. This specific risk plays a critical role in the management and treatment strategies for APL, highlighting the importance of recognizing the hematologic abnormalities associated with this form of leukemia.