title: Prevalence and clinical characteristics of acute myeloid leukemia associated with disseminated intravascular coagulation.
abstract: 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.
authors: Department of Medicine and Clinical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan. huchiumi@med.gunma-u.ac.jp
authors: Hideki
authors: H
authors: Uchiumi
authors: Takafumi
authors: T
authors: Matsushima
authors: Arito
authors: A
authors: Yamane
authors: Noriko
authors: N
authors: Doki
authors: Hiroyuki
authors: H
authors: Irisawa
authors: Takayuki
authors: T
authors: Saitoh
authors: Tohru
authors: T
authors: Sakura
authors: Takahiro
authors: T
authors: Jimbo
authors: Hiroshi
authors: H
authors: Handa
authors: Norifumi
authors: N
authors: Tsukamoto
authors: Masamitsu
authors: M
authors: Karasawa
authors: Shuichi
authors: S
authors: Miyawaki
authors: Hirokazu
authors: H
authors: Murakami
authors: Yoshihisa
authors: Y
authors: Nojima
mesh_terms: 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
chemical_list: D006684:HLA-DR Antigens; D002097:C-Reactive Protein; D018826:CD13 Antigens