A 39-year-old woman presents with gingival bleeding and bruising. Hemoglobin is 82 g/L, platelets 18 x 10^9/L, fibrinogen is 0.8 g/L, INR is 1.8, and

Question

A 39-year-old woman presents with gingival bleeding and bruising. Hemoglobin is 82 g/L, platelets 18 x 10^9/L, fibrinogen is 0.8 g/L, INR is 1.8, and the smear shows abnormal promyelocytes with heavy granulation and Auer rods. Cytogenetics are pending. What is the most appropriate management?

Accepted Answer

Start ATRA immediately with aggressive blood product support

Answer

Begin high-dose corticosteroids for immune thrombocytopenia

Answer

Wait for cytogenetic confirmation before treatment

Answer

Start hydroxyurea and outpatient hematology review

Answer

Give platelet transfusion alone and repeat smear

Acute promyelocytic leukemia — RCPSC IM MCQ

A 39-year-old woman presents with gingival bleeding and bruising. Hemoglobin is 82 g/L, platelets 18 x 10^9/L, fibrinogen is 0.8 g/L, INR is 1.8, and the smear shows abnormal promyelocytes with heavy granulation and Auer rods. Cytogenetics are pending. What is the most appropriate management?