Prevalence and clinical characteristics of acute myeloid leukemia associated with disseminated intravascular coagulation.
Disseminated intravascular coagulation (DIC) is one of the important complications to develop in patients with acute myeloid leukemia (AML). While acute promyelocytic leukemia (APL) is a strong risk factor for DIC, other clinical features have not been fully defined. We retrospectively analyzed 161 consecutive adult patients with de novo non-APL AML. DIC was diagnosed in 52 patients (32%); 28 patients at diagnosis and 24 soon after the initiation of induction chemotherapy. Leukocyte counts, C-reactive protein, and lactate dehydrogenase were significantly higher in the DIC+ group. Negative expressions of CD13, CD19, CD34, and HLA-DR were more prevalent in the DIC+ group. On multivariate logistic-regression analysis, variables that were independently associated with the development of DIC were high C-reactive protein, high leukocyte count, negative expressions of CD13 and HLA-DR, and cytogenetics with a normal karyotype or 11q23 abnormality. Although DIC is considered to be associated with serious morbidity and occasional mortality, we did not find any significant differences in the complete remission rate, overall or disease-free survival between DIC+ and DIC- groups. This study is the first to define the clinical characteristics associated with DIC in patients with non-APL AML, but exactly how and when DIC should be treated remains to be determined.
Uchiumi
Hideki
H
Department of Medicine and Clinical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan. huchiumi@med.gunma-u.ac.jp
Matsushima
Takafumi
T
Yamane
Arito
A
Doki
Noriko
N
Irisawa
Hiroyuki
H
Saitoh
Takayuki
T
Sakura
Tohru
T
Jimbo
Takahiro
T
Handa
Hiroshi
H
Tsukamoto
Norifumi
N
Karasawa
Masamitsu
M
Miyawaki
Shuichi
S
Murakami
Hirokazu
H
Nojima
Yoshihisa
Y
D000208:Acute Disease; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D018826:CD13 Antigens / Q000032:analysis; D002880:Chromosomes, Human, Pair 11; D003582:Cytogenetics; D004211:Disseminated Intravascular Coagulation / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D007951:Leukemia, Myeloid / Q000150:complications*; D007958:Leukocyte Count; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D012189:Retrospective Studies; D016896:Treatment Outcome
D006684:HLA-DR Antigens; D002097:C-Reactive Protein; D018826:CD13 Antigens