Dixit Ashish, Chatterjee Tathagat, Mishra Pravas, Kannan Meganathan, Choudhry Dharma R, Mahapatra Manoranjan, Choudhry V P, Saxena Renu
Department of Haematology, All India Institute of Medical Sciences, New Delhi, India.
Clin Appl Thromb Hemost. 2007 Jul;13(3):292-8. doi: 10.1177/1076029607302435.
Between January 2001 and December 2003, 67 patients with acute leukemia were evaluated prospectively 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.
2001年1月至2003年12月期间，对67例急性白血病患者在初诊时进行了止血异常的前瞻性评估，其中43例（64.2%）为急性淋巴细胞白血病，24例（35.8%）为急性髓细胞白血病。初诊时，27例患者（40.3%）有出血表现。57例患者（85%）存在血小板减少，33例（49.3%）有一些全血凝固指标异常。弥散性血管内凝血根据国际血栓与止血学会标准定义。与急性淋巴细胞白血病病例相比，弥散性血管内凝血在急性髓细胞白血病病例中更常与出血表现相关。2例患者在化疗第7天出现弥散性血管内凝血，无任何出血表现。诱导治疗第7天后出现出血或感染并发症的15例评估病例中，有4例也发生了弥散性血管内凝血。建议所有白血病患者在初诊时进行弥散性血管内凝血检查。
