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Disseminated Intravascular Coagulation at Diagnosis in Acute Myeloblastic Leukaemia

Journal of Biosciences and Medicines 2021年第10期9卷 124-134页

作者： Masba uddin Chowdhury Masuda Begum Md. Rafiquzzaman Khan Amin Lutful Kabir Shafiqul Islam Khushbun Nahar Layla Fahmida Ahamed jamal uddin tanin Department of Haematology & HSCT Evercare Hospital Dhaka Bangladesh Department of Haematology Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh Department of Physiology Ibrahim Medical College & Hospital Dhaka Bangladesh Department of Haematology Imperial Hospital Limited Chittagong Bangladesh Parkview Hospital Chittagong Bangladesh

Background: Disseminated Intravascular Coagulation (DIC) is a life threatening complication frequently observed in acute leukemia. Among the morphological varieties of Acute Myeloid Leukaemia (AML), Acute Promyelocytic Leukaemia (APL) is well established to cause DIC. But there have been reports noted that abnormal DIC parameters also commonly observed in the patients with non-APL AML. This study evaluated the DIC parameters & DIC score according to International Society of Thrombosis and Haemostasis (ISTH) in newly diagnosed non-APL AML patients. Materials and Methods: This cross-sectional observational study was conducted in the Department of Haematology, BSMMU, Dhaka, Bangladesh. 48 newly diagnosed non-APL AML patients were enrolled. Platelets count was measured by auto analyzer (Sysmax XT 2000i/Pentra ABX-120DX) as well as checked manually. Prothrombin time, fibrinogen, D-Dimer were measured using STAGO Coagulation analyzer. The ISTH-DIC scoring system was used to calculate DIC score. The statistical analysis was carried out using the Statistical Package for Social Sciences version 24.0 for Windows. Chi-Square test & Fisher exact test was used for categorical variables. Unpaired t-test was used to compare mean between groups. For all statistical tests, p-value less than 0.05 was considered as statistically significant. Results: By analyzing 48 newly diagnosed patients with non-APL AML, found that DIC developed in 14.6% patients at presentation. Among the DIC parameters, PT and D-dimer were significantly higher in patients presented with DIC. Patients with DIC exhibit lower expression of CD117, CD34, HLA-DR and statistically significant association with negative expression of HLA-DR (p-value 0.034). No significant association was found between presence of DIC and age, gender, bleeding at presentation, morphological type, WBC count or peripheral blast percentage. Conclusion: Abnormalities of DIC p

关键词： Acute Myeloblastic Leukaemia Disseminated Intravascular Coagulation ISTH-DIC Scoring System

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