[Clinical study on the fibrinolytic activity in patients with acute promyelocytic leukemia].
OBJECTIVE
To study the fibrinolytic activity in patients with acute promyelocytic leukemia (APL) and its alteration in all-trans retinoic acid (ATRA) and/or arsenic trioxide (ATO) treatment.


METHODS
Plasma fibrinogen concentration was determined with the conventional method, and the levels of fibrin degradation products (FDP) and D-dimer were quantified with ELISA. Plasminogen was measured by chromogenic assay. Cell surface expression of Annexin II and u-PAR and their mRNA levels were measured by flow cytometry and real time-PCR, respectively.


RESULTS
The levels of FDP and D-dimer in APL were remarkably higher in APL patients than that in normal controls, while fibrinogen and plasminogen were lower. Both Annexin II and u-PAR were highly expressed on APL cells, which declined after treatment with ATRA and/or ATO, but remained higher than those on normal bone marrow mononuclear cells.


CONCLUSIONS
Abnormally high levels of Annexin II and u-PAR expression on APL cells may contribute to the increased production of plasmin, leading to primary hyperfibrinolysis in APL. ATRA and ATO therapy induces down-regulation of Annexin II and u-PAR expression, which may be contribute, at least in part, to the relief of the hemorrhagic complications in APL.
Liu
Yan-Hui
YH
First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Suzhou 215006, China.
Wang
Zhao-Yue
ZY
Zhang
Wei
W
Dai
Lan
L
Shen
Wen-Hong
WH
Ruan
Chang-Geng
CG
D000293:Adolescent; D000328:Adult; D000368:Aged; D017306:Annexin A2 / Q000032:analysis; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000627:therapeutic use; D005260:Female; D005342:Fibrinolysis; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010087:Oxides / Q000627:therapeutic use; D012333:RNA, Messenger / Q000235:genetics; D014212:Tretinoin / Q000627:therapeutic use; D014568:Urokinase-Type Plasminogen Activator / Q000032:analysis; D055815:Young Adult
D017306:Annexin A2; D001152:Arsenicals; D010087:Oxides; D012333:RNA, Messenger; D014212:Tretinoin; D014568:Urokinase-Type Plasminogen Activator; D000077237:Arsenic Trioxide