Faculty Collaboration Database

The coagulopathy of childhood leukemia. Thrombin activation or primary fibrinolysis? Cancer 1990 Aug 15;66(4):716-21

Date

08/15/1990

Pubmed ID

2386901

DOI

10.1002/1097-0142(19900815)66:4<716::aid-cncr2820660420>3.0.co;2-b

Scopus ID

2-s2.0-0025003474 (requires institutional sign-in at Scopus site)   37 Citations

Abstract

Little information is available on the prevalence and etiology of the coagulopathy present in some children with acute leukemia at disease presentation. We studied 102 children with newly diagnosed acute leukemia (50 retrospective: Group A; and 52 prospective: Group B) with prothrombin time (PT), partial thromboplastin time (PTT), thrombin time (TT), fibrinogen (FIB), and fibrin degradation products (FDP). All patients in Group B also had assessment of thrombin activation by measurement of the crosslinked fibrin fragment, D-dimer, and of primary fibrinolysis with the B beta 1-42 peptide. Additionally, ten patients from Group B had Factors II, V, VII, and X measured, and eight of these patients had measurement of tissue factor from sonicated bone marrow cells. Thirty-two percent of Group A and 40% of Group B had totally normal coagulation studies, whereas 20% of Group A and 10% of Group B had a severe coagulopathy on disease presentation. A high percentage of both groups had elevated PT (Group A, 52%; Group B, 27%) and increased FDP (Group A, 39%; Group B, 25%). In Group B, 38% of the patients had a positive D-dimer, whereas only 4% of this prospective group had an elevated B beta 1-42 peptide (P less than 0.00001). Nine of ten patients with a positive D-dimer had low levels of one or more of the extrinsic pathway factors. Three of four patients with the highest tissue factor levels were of monocytoid leukemia cell type. These data indicate that the coagulopathy associated with acute leukemia of childhood is usually mediated by thrombin activation.

Author List

Abshire TC, Gold SH, Odom LF, Carson SD, Hathaway WE

MESH terms used to index this publication - Major topics in bold

Adolescent
Blood Coagulation Disorders
Child
Child, Preschool
Fibrin Fibrinogen Degradation Products
Fibrinolysis
Fibrinopeptide B
Humans
Infant
Peptide Fragments
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Prevalence
Prospective Studies
Prothrombin Time
Retrospective Studies
Thrombin