Disseminated Intravascular Coagulation in Acute Leukemia at Presentation and During Induction Therapy

Dixit, Ashish DM
Chatterjee, Tathagat DM
Mishra, Pravas DM
Kannan, Meganathan MSc
Choudhry, Dharma R. DM
Mahapatra, Manoranjan MD
Choudhry, V. P. MD
Saxena, Renu MD

Department of Haematology, All India Institute of Medical Sciences, New Delhi, India

Address correspondence to: Dr Renu Saxena, Professor, Department of Haematology, All India Institute of Medical Sciences, IRCH Building 1st Floor, Ansari Nagar, New Delhi 110 029, India; e-mail: [email protected].

Clinical & Applied Thrombosis/Hemostasis 13(3):p 292-298, July 2007.

Summary

Between January 2001 and December 2003, 67 patients with acute leukemia were evaluated prospec-tively for hemostatic abnormality at presentation, of which 43 (64.2%) had acute lymphoblastic leukemia and 24 (35.8%) had acute myelogenous leukemia. At presentation, 27 patients (40.3%) had bleeding manifestations. Thrombocytopenia was present in 57 patients (85%), and 33(49.3%) had some abnormality of global coagulation markers. Disseminated intravascular coagulation was defined by International Society of Thrombosis and Hemostasis criteria. Disseminated intravascular coagulation was more often associated with bleeding manifestations in acute myelogenous leukemia cases than in acute lymphoblastic leukemia cases. Two patients presented disseminated intravascular coagulation on day 7 of chemotherapy, without any bleeding manifestations. Four of 15 evaluated cases who had a bleeding or infection complication after day 7 of induction therapy also had disseminated intravascular coagulation. It is recommended that all patients with leukemia be investigated for disseminated intravascular coagulation at presentation.