Soru

A 41-year-old woman is evaluated in the emergency department for a 2-day history of severe epistaxis, easy bruising, and profound fatigue. Laboratory studies reveal a hemoglobin of $7.8 \text{ g/dL}$, a leukocyte count of $1,200/\mu\text{L}$, and a platelet count of $18,000/\mu\text{L}$. Coagulation studies show a prolonged prothrombin time, a prolonged activated partial thromboplastin time, a significantly elevated D-dimer, and a fibrinogen level of $85 \text{ mg/dL}$ (normal: $150-400 \text{ mg/dL}$). The patient is suspected to have acute promyelocytic leukemia (APL). Arrange the following diagnostic and therapeutic steps in the most appropriate chronological sequence for managing this patient.