Treatment of DIC associated with APL.

risk of allosensitization because of multiple transfusions, but intracerebral hemorrhage rates of 10%' or 15%' still represent an unacceptably high risk in patients with disseminated intravascular coagulopathy and acute leukemia. The recent by Rodeghiero' suggests that uncertainty hours.2 Further refinements may ultimately reduce the theoretical exists on how to prevent intracerebral hemorrhage in patients with acute promyelocytic leukemia undergoing induction therapy. Patients treated with either heparin, antifibrinolytics, and supportive care alone all experienced a comparable incidence of early hemorrhagic death (approximately 9%). . _ _ While controversy may still persist in relation to optimal therapy, it should be clearly understood that virtual elimination of intracerebral hemorrhage occurs with the application of intravenous heparin, 7.5 to 12.5 U/kg/h accompanied by infusions of fresh frozen plasma with 6 U of platelets every 12 hours. This method has now been applied to induction therapy in 61 ZALMEN A. ARLIN ERIC J. FELDMAN Division of Neoplastic Diseases New York Medical College Valhalla