CLINICAL NEWS
Disseminated Intravascular Coagulation: A Predictor for Arterial and
Venous Thrombosis in Patients with Acute Myeloid Leukemia
About 10 percent of adult patients
with acute myeloid leukemia (AML)
treated with intensive chemotherapy
developed venous or arterial thrombosis, according to results from
a prospective study published in
Blood. Study authors, led by Eduard
J. Libourel, MD, from the Department of Hematology/Oncology at
the Sint Franciscus Gasthuis in Rotterdam, the Netherlands, also found
that disseminated intravascular
coagulation (DIC) at AML diagnosis could identify patients likely to
develop thrombosis.
“Thrombosis is a well-known
complication in patients with
malignancy; however, it is not well
known how often this occurs in
AML patients,” co-author Frank W.
G. Leebeek, MD, PhD, from the
Erasmus University Medical Centre
fibrinogen levels, D-dimer levels,
platelet count, prothrombin time
[PT], anti-thrombin levels, and
alpha-2 anti-plasmin levels) were
measured at AML or MDS diagnosis. No patients received anticoagulant prophylaxis and imaging
studies were performed to confirm
the diagnosis of thrombotic events.
The prevalence of thrombosis
was 8.7 percent in the younger
cohort: 4.7 percent venous
thrombosis and 4 percent arterial
thrombosis.
Among the AML patients:
• 2.9% had pulmonary embolism
(PE)
• 1.4% had venous thrombosis
of the leg
• 0.4% had thrombosis of the
upper extremity
• 1.5% had PE
• 2.2% had venous thrombosis
of the leg
• 0.7% had thrombosis of the
upper extremity
“Hematologists should be aware
that thrombosis – both venous and
arterial – occur frequently in patients
with AML,” Dr. Leebeek told ASH
Clinical News. “If patients present
with symptoms suggestive of deep
vein thrombosis or PE, adequate
diagnostics should be performed.”
DIC scores (per the International Society on Thrombosis
and Hemostasis DIC scores) were
available for 99 percent of patients in
the younger cohort (n=270) and 95
percent in the older cohort (n=126).
DIC incidence (defined as an
ISTH DIC score ≥5