title: Combined procoagulant activity and proteolytic activity of acute promyelocytic leukemic cells: reversal of the bleeding disorder by cell differentiation.
abstract: In the human promyelocytic cell line HL60, we observed both a strong procoagulant activity (PCA) on the cell membrane and proteolytic activity in the lysate of these cells. Because these cell-line cells are susceptible to differentiation to either a more mature granulocytic or monocytic form, we were able to study the hypothesis that the combination of PCA and proteolytic activity is confined to the promyelocyte. This may explain the severe coagulopathy seen in patients with acute promyelocytic leukemia. Cell differentiation in a myeloid direction induced by retinoic acid or DMSO led to a diminished PCA, while not affecting the fibrinolytic activity. On the other hand, monocytic differentiation obtained by culturing the cells in the presence of 1; 25 dihydroxy vitamin D3 led to the complete disappearance of the proteolytic activity of the cell lysate, although the procoagulant activity was still present. Furthermore, we found that the elastase activity almost disappeared after monocytic differentiation. We also studied the PCA, proteolytic activity, and elastase activity of blast cells of patients with acute myeloid leukemia. Only in patients with acute promyelocytic leukemia did we observe both a strong PCA and fibrinolytic activity. This supports our hypothesis that the combination of these activities is unique to the promyelocyte and may explain the observed bleeding complications in patients with acute promyelocytic leukemia.
authors.affiliation: Free University Hospital, Department of Haematology, Amsterdam, The Netherlands.
authors.forename: P W
authors.initials: PW
authors.lastname: Wijermans
authors.forename: V I
authors.initials: VI
authors.lastname: Rebel
authors.forename: G J
authors.initials: GJ
authors.lastname: Ossenkoppele
authors.forename: P C
authors.initials: PC
authors.lastname: Huijgens
authors.forename: M M
authors.initials: MM
authors.lastname: Langenhuijsen
mesh_terms: D001777:Blood Coagulation; D002454:Cell Differentiation / Q000187:drug effects; D005342:Fibrinolysis; D006801:Humans; D066298:In Vitro Techniques; D015473:Leukemia, Promyelocytic, Acute / Q000503:physiopathology*; D010196:Pancreatic Elastase / Q000378:metabolism; D010447:Peptide Hydrolases / Q000378:metabolism*; D013755:Tetradecanoylphorbol Acetate / Q000494:pharmacology; D014407:Tumor Cells, Cultured
chemical_list: D010447:Peptide Hydrolases; D010196:Pancreatic Elastase; D013755:Tetradecanoylphorbol Acetate