fibrin and Leukemia--Myeloid

To describe an unusual ocular manifestation of a patient with acute myeloid leukemia (AML).. Observational case report.. A 59-year-old woman with a history of preleukemic myelodysplastic syndrome (MDS) and status post bone marrow transplant (BMT) complained of a sudden onset of poor vision associated with a corneal pseudomembrane. Ocular graft vs host disease was suspected, and the pseudomembrane was excised for histopathologic examination.. The pseudomembrane showed myeloblasts admixed with an acute inflammatory response suggestive of the development of AML, a complication of MDS. Bone marrow examination confirmed the diagnosis of relapsing AML.. Acute myeloid leukemia could present as a pseudomembrane; thus, examination of relevant ocular tissue is recommended.

Topics: Acute Disease; Bone Marrow; Bone Marrow Transplantation; Corneal Diseases; Female; Fibrin; Graft vs Host Disease; Humans; Leukemia, Myeloid; Membranes; Middle Aged; Neoplasm Recurrence, Local

The bone marrow of a 53-year-old woman with acute myeloid leukemia (AML) with disseminated intravascular coagulation was investigated by transmission electron microscopy. The patient had a preceding granulocytic sarcoma, and subclinical disseminated intravascular coagulation occurred concomitantly with the development of AML. Ultrastructural findings of the bone marrow at the onset of AML revealed the following: (1) The cytoplasm of the leukemic cells showed frequent fragmentation, resulting in the formation of abundant cytoplasmic fragments. (2) These cytoplasmic fragments were surrounded by abundant fibrin fibers, forming the fibrin-cytoplasmic fragment complex (FCF complex). (3) Slight fibrin deposition was seen around the leukemic cells and in the intercellular space of the bone marrow. Fibrin deposition in the bone marrow is thought to represent morphologic evidence of disseminated intravascular coagulation. The damage on the leukemic cell surface due to the cytoplasmic fragmentation seems to be closely related to the development of disseminated intravascular coagulation.

Topics: Acute Disease; Antigens, CD; Blood Coagulation Tests; Bone Marrow; Cytoplasm; Disseminated Intravascular Coagulation; Female; Fibrin; Fibrinogen; Humans; Leukemia, Myeloid; Middle Aged

Blood coagulation, fibrinolytic and unspecific proteolytic parameters were investigated in 34 patients with acute myeloid leukemia. An increased activity of the coagulation system, documented by elevated thrombin-antithrombin III-complex (TAT) plasma levels, was found in 91% of the patients; 50% had increased elastase plasma levels. Hyperfibrinolysis, as shown by elevated fibrin split-product D-Dimer plasma levels, was detected in 91% of AML patients. Activation of these enzyme systems was not associated with relevant defects in blood coagulation or fibrinolysis in the majority of the patients investigated. In selected cases of promyelocytic M3 and monoblastic M5 leukemia, however, hypofibrinogenemia and alpha 2-plasmininhibitor deficiency was found, most likely due to depletion of these proteins in the course of disseminated intravascular coagulation and secondary hyperfibrinolysis. Significant correlations were calculated between TAT and fibrinogen (r = -0.57, P less than 0.005), TAT and D-Dimer (r = 0.89, P less than 0.0005), and D-Dimer and alpha 2-plasmininhibitor (r = -0.77, P less than 0.0005) levels. Indications of a pathogenetic importance of primary hyperfibrinolysis or unspecific proteolysis for hypofibrinogenemia and alpha 2-PI deficiency were not found.

Topics: Acute Disease; Adult; Aged; Aged, 80 and over; alpha-2-Antiplasmin; Antithrombins; Blood Coagulation; Female; Fibrin; Fibrinogen; Fibrinolysis; Hemostasis; Humans; Leukemia, Myeloid; Male; Middle Aged; Peptide Hydrolases; Reference Values; Thrombin

This study was made to know the significance of fibrinopeptide A(FPA) as an indicator for coagulative analysis in thrombotic diseases. In normal control subjects (n=21), values of FPA by the radioimmunoassay were 0.5 +/- 1.4 ng/ml (mean +/- SD). In animal models, using Lyoplastin (tissue thromboplastin, n=5) or Ancrod (n=5) to piglets, plasma FPA levels elevated rapidly as a reflection of fibrin formation, and these changes of FPA were found to be most rapid and sensitive among the indicators for coagulation and fibrinolysis. In patients with thrombosis (n=32), elevated FPA levels (14.7 +/- 13.8 ng/ml) and beta-thromboglobulin (beta-TG)(86.1 +/- 65.6 ng/ml) were found. FPA levels in these patients positively correlated to beta-TG (r=0.5539, P less than 0.05) and inversely to fibrinogen (fbg) (r= -0.3622, P less than 0.05). In patients with acute myelocytic leukemia (AML, n=112), acute promyelocytic leukemia (APL, n=18) and acute lymphocytic leukemia (ALL, n=15), mean FPA levels in patients with active signs and symptoms were significantly higher (AML: 13.5 ng/ml, APL: 20.8 ng/ml, ALL: 12.4 ng/ml) than those examined during remission states (AML: 7.7 ng/ml, P less than 0.02, APL: 3.9 ng/ml, P less than 0.01, ALL: 2.7 ng/ml, P less than 0.01). FPA levels in patients with APL inversely correlated to fbg (r= -0.6399, P less than 0.01). In patients with lung cancer (n=75), mean FPA level in advanced stage (17.7 ng/ml, n=67) were significantly higher than those examined in early stage 6.5 ng/ml, n=8, P less than 0.001). In patients with acute disseminated intravascular coagulation (n=12), prolonged prothrombin time and activated partial thromboplastin time, severely reduced fbg and platelets, and remarkably elevated fibrin degradation product were found. Elevated FPA and beta-TG levels were also found (FPA: 23.5 +/- 15.0 ng/ml, beta-TG: 100.0 +/- 63.0 ng/ml). In five patients with thrombotic diseases who were treated successfully with 12500 IU of heparin per 12 hours (subcutaneous injection), plasma FPA levels were reduced to near normal levels quicker than changes of other indicators. These clinical and experimental data suggested that FPA was an useful indicator for active coagulation process.

Topics: Adult; Animals; Blood Coagulation; Disseminated Intravascular Coagulation; Female; Fibrin; Fibrinogen; Fibrinopeptide A; Heparin; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Lung Neoplasms; Male; Radioimmunoassay; Swine; Thrombosis

Topics: Acute Disease; Antithrombins; Blood Cell Count; Blood Coagulation Tests; Disseminated Intravascular Coagulation; Fibrin; Fibrinogen; Fibrinolysis; Hemorrhage; Humans; Leukemia; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Liver Cirrhosis; Lymphatic Diseases; Platelet Adhesiveness; Prothrombin Time; Retinal Detachment; Thrombin; Thrombophlebitis

Topics: Adult; Aged; Antigens; Blood Coagulation; Disseminated Intravascular Coagulation; Female; Fibrin; Fibrinogen; Humans; Immunodiffusion; Immunoelectrophoresis; Leukemia, Myeloid; Male; Middle Aged; Plasma; Prostatic Neoplasms; Thrombin

Topics: Acute Disease; Adenine Nucleotides; Adenosine Diphosphate; Adult; Aged; Blood Platelets; Collagen; Epinephrine; Female; Fibrin; Humans; Kaolin; Leukemia; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Lymphoma, Non-Hodgkin; Male; Middle Aged; Muramidase; Platelet Adhesiveness; Remission, Spontaneous; Thrombin

Topics: Blood Coagulation; Blood Coagulation Tests; Fibrin; Fibrinogen; Humans; Leukemia; Leukemia, Myeloid; Leukocyte Count; Leukocytes

Topics: Blood Coagulation Tests; Factor IX; Fibrin; Fibrinolysis; Humans; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Leukemia, Myeloid; Medical Records

Topics: Afibrinogenemia; Fibrin; Fibrinogen; Fibrinolysis; Humans; Leukemia; Leukemia, Myeloid; Leukemia, Myeloid, Acute

Topics: Abdomen; Fibrin; Hemorrhage; Humans; Leukemia; Leukemia, Myeloid; Spleen; Splenomegaly

Topics: Fibrin; Fibrinolysis; Hemorrhage; Humans; Leukemia; Leukemia, Myeloid; Syndrome