A Case of Ischemic Stroke in Acute Promyelocytic Leukemia at Initial Presentation: Relevance of All-Trans Retinoic Acid Treatment

Acute promyelocytic leukemia (APL) is frequently associated, often from the earliest phases, with a lifethreatening coagulation/bleeding syndrome; disseminated intravascular coagulation (DIC) is described in majority of patients. We report a case of 49-year-old male, without cardiovascular risk factors, who suddenly developed ischemic stroke and splenic infarction as presenting symptoms of APL and related DIC. The patient was immediately treated with all-trans retinoic acid (ATRA) and the alterations of hemocoagulation parameters promptly returned in normal range. The coagulation/ bleeding syndrome of the onset of APL is associated with high mortality; both diagnostic and therapeutic approaches require special and timely consideration of this condition. Treatment with ATRA is essential.