A 41-year-old woman presents with progressive fatigue, spontaneous gingival bleeding, and easy bruising. Vital signs show BP 118/76, HR 102, RR 18, temperature 37.2°C, SpO2 98% on room air. Laboratory studies reveal WBC 8,200/μL with pancytopenia, platelet count 18,000/μL, fibrinogen 95 mg/dL, and elevated D-dimer. Bone marrow biopsy demonstrates abnormal promyelocytes with multiple Auer rods. Coagulation studies are abnormal; no recent anticoagulant use. Which of the following is the best targeted therapy?
- A)Trastuzumab
- B)Imatinib
- C)Vincristine alone
- D)All trans retinoic acidGABARITO
- E)Rituximab
Explicação
All trans retinoic acid is correct. Acute promyelocytic leukemia is caused by t(15;17), which blocks myeloid differentiation through abnormal retinoic acid receptor signaling. ATRA relieves that block and is a cornerstone of therapy, particularly important bec... Ver explicação completa e trilha adaptativa →