The Diagnostic Efficency Of Coagulative And Fibrinolytic Parameters In Disseminated Intravascular Coagulation Induced By Acute Promyelocytic Leukemia

Acute promyelocytic leukemia(APL)in which more than 20%of the cells are malignant promyelocytes in bone marrow blood cells,often associated with disseminated intravascular coagulation(DIC),initiated by the release of procoagulant activity from leukemic cells.Primary fibrinogenolysis,mediated by the release of leukocyte proteases,may also contribute to this disorder.To diagnosis the DIC induced by APL is through the platelet count,coagulative and fibrinolytic parameters.These parameters are related to this disease.Objective:To explorer the alterations and correlation of the coagulative and fibrinolytic with DIC induced by APL and assessment the parameters diagnostic efficency.Method:A series of hemostatic and fibrinolytic parameters were measured among 67 cases of DIC induced by APL using ELISA and compare the turbidity,including activated partial thromboplastin(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(Fg),tissue-type plasminogen activator(t-PA)and plasminogen activator inhibitor-1(PAI—1).Results:APL patients showed anemia to some extent according to the clinical symptoms and routine blood test results.The white blood count and platelet count also decreased.The percentage of primitive malignant cells elevated obiviously in bone marrow.Abnormal chromosome and PML/RAR alpha fusion gene were seen in most cases.The plasma level of PAI-1 was elevated significantly in patients with DIC induced by APL than in controls.Plasma t-PA antigen was dicreased in patients with DIC induced by APL.The Plasma of PAI-1,t-PA were corealation with the APTT,PT.The Plasma of PAI-1,t-PA were not corealation with the APTT,PT.Conclusion:It suggests that the alteration of coagulative and fibrinolytic systems play an important role in the DIC.