Abstract
Recent information as well as our retrospective review of 50 patients (Group A) demonstrates that a coagulopathy is commonly seen at presentation in childhood leukemia. In order to determine whether the coagulopathy was primarily thrombin mediated (DIC) or plasmin mediated (primary fibrinolysis), a prospective evaluation of 30 untreated new onset acute leukemia patients (group B) was instituted. Studies were: PT, PTT, thrombin time (TT), fibrinogen (Fib), serum FDP, D-dimer (DD) and B-beta 1-42 peptide (BB). The DD is a measure of thrombin activation whereas the BB best defines primary fibrinolysis.
Only 32% (Group A) and 23% (Group B) had totally normal coagulation screens. Most notable is the high proportion of each group with elevated PT and/or positive FDP. In Group B, the DD was strikingly positive whereas the BB was essentially negative. These data indicate the mechanism of the coagulopathy of acute leukemia on presentation of disease is primarily thrombin activated coagulation. The incidence of increased PT lends support to a Tissue Factor/Factor VII complex causing activation of coagulation. Studies are underway to further elucidate the pathogenesis of the coagulopathy.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Gold, S., Abshire, T., Jamison, B. et al. THE COAGULOPATHY OF CHILDHOOD LEUKEMIA: DIC OR PRIMARY FIBRINOLYSIS?. Pediatr Res 21 (Suppl 4), 299 (1987). https://doi.org/10.1203/00006450-198704010-00790
Issue Date:
DOI: https://doi.org/10.1203/00006450-198704010-00790