[Hemostatic variations associated with acute leukemia: clinical and prognostic significance].
OBJECTIVE
To study the hemostatic abnormalities and their association with bleeding manifestation and prognosis in acute leukemia (AL) patients.


METHODS
A series of hemostatic parameters were determined in 93 cases of AL using ELISA or chromogenic assay.


RESULTS
At diagnosis, plasma levels of P-selectin, soluble fibrinomonomer complex (SFMC), thrombomodulin (TM), tissue plasminogen activator, D-dimer (D-D) were significantly elevated, but protein C antigen (PC:Ag), plasminogen (PLG), alpha(2)-antiplasmin (alpha(2)-PI) and plasminogen activator inhibitor (PAI) were decreased, and fibrinogen (Fg), PC activity (PC:A) and protein S (PS) were in normal range. All the above abnormalities returned to normal after complete remission (CR) except for PC:A and PC:Ag. Platelet counts, Fg, SFMC, PLG, alpha(2)-PI and D-D were significantly associated with hemorrhagic manifestations. TM, PS and PAI were related to prognosis.


CONCLUSIONS
There existed the consumption of platelets as well as the activation of coagulant, anticoagulant and fibrinolytic systems in AL, which was greatly improved after CR.
Zhao
W
W
Shanghai Institute of Hematology, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China.
Wang
X
X
Qu
B
B
Hu
J
J
Sheng
Z
Z
Wang
H
H
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001780:Blood Coagulation Tests; D001798:Blood Proteins / Q000378:metabolism*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006801:Humans; D007938:Leukemia / Q000097:blood* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood; D010958:Plasminogen / Q000378:metabolism; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism; D017293:Protein S / Q000378:metabolism; D012074:Remission Induction; D016019:Survival Analysis; D018180:Thrombomodulin / Q000378:metabolism; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000378:metabolism
D001798:Blood Proteins; D005338:Fibrin Fibrinogen Degradation Products; D019007:P-Selectin; D017395:Plasminogen Activator Inhibitor 1; D017293:Protein S; D018180:Thrombomodulin; C036309:fibrin fragment D; D010958:Plasminogen; D010959:Tissue Plasminogen Activator