Leukemia research
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High-dose chemotherapy and autologous stem-cell transplantation (HDT-ASCT) is standard therapy for younger patients with multiple myeloma (MM) who are physically fit enough to undergo the treatment. Nevertheless, MM remains incurable and strategies to prevent or delay relapse after HDT-ASCT are needed. ⋯ Alternatively, extending treatment with novel induction regimens may delay the need for HDT-ASCT. Although there is some clinical evidence to support the use of these strategies, their efficacy has not been proven definitively in clinical trials; ongoing studies should help determine their merit in transplant-eligible patients with MM.
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We treated individuals for disseminated intravascular coagulation (DIC) caused by acute promyelocytic leukemia (APL) (n=9) using human soluble thrombomodulin (rTM) in combination with all-trans retinoic acid (ATRA) and chemotherapy, and compared the clinical outcomes with historical control patients (n=8) treated with ATRA and/or chemotherapy. Two control patients developed intracranial vascular incidents. ⋯ Notably, treatment with rTM rescued patients from DIC earlier than historical controls (log rank test, p=0.019). These results suggest that administration of rTM should be considered for the treatment of individuals with DIC associated with APL.