[Intravascular coagulation in acute promyelocytic leukemia: analysis of coagulation and fibrinolysis parameters].
Eight pts with acute myeloid leukemia were studied to assess coagulation and fibrinolysis disturbances as a cause of hemorrhages associated to thrombopenia. Fibrinogen, products of fibrinogen to fibrin degradation, D-dimer, antithrombin III, protein C, plasminogen and alpha-2 antiplasmin determinations were performed at admission, during and after chemotherapy. All pts were on heparin during induction chemotherapy. Coagulation activation, which increased with the onset of chemotherapy (increases in D-dimer) and a decreasing trend at the end of the antileukemic therapy (normalization of fibrinogen levels) was observed. During the whole observation period alpha-2 antiplasmin levels remained very low. No significant changes were observed in antithrombin III or protein C levels. In conclusion, disseminated intravascular coagulation with associated thrombopenia is an important event in acute leukemia and an increased fibrinolytic activity due to low alpha-2 antiplasmin levels may take part in the genesis of hemorrhage. These data suggest that both heparin administration and the use of antifibrinolytic drugs may have a therapeutic effect.
Chuecas
F
F
Departamento y Laboratorio de Hematología-Oncología, Facultad de Medicina, P. Universidad Católica de Chile, Santiago.
Loredo
E
E
Muñoz
B
B
Alfaro
J
J
Grebe
G
G
Lira
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000150:complications*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis; D005342:Fibrinolysis; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000097:blood / Q000150:complications*; D008297:Male; D008875:Middle Aged; D013921:Thrombocytopenia / Q000150:complications
D005338:Fibrin Fibrinogen Degradation Products; D005340:Fibrinogen
Coagulación intravascular en leucemia aguda promielocítica: análisis de parametros de coagulación y fibrinolisis.