Disseminated intravascular coagulopathy in non-promyelocytic acute myeloid leukemia- incidence, clinical and laboratory features and prognostic significance
Abstract
Introduction/Aim: Acute promyelocytic leukemia (APL) has the highest risk for overt disseminated intravascular coagulopathy (DIC), with reported incidence of DIC up to 90%, compared to 10-40% in other AML types. The influence of DIC on early death in non-APL AML patients is not evaluated so far. Aim of our study was to analyze of the incidence of DIC in non-APL AML, its clinical and laboratory characteristics, and impact on survival and early death of patients with non-APL AML.
Methods: Total of 176 patients with non-APL AML diagnosed and treated at the Clinic of Hematology Clinical Center Serbia between 2015-2020 were evaluated retrospectively. The diagnosis of DIC was made on the basis of ISTH (International Society on Thrombosis and Haemostasis) criteria.
Results: Mean age of our patients was 53.8 ± 14.6 year, 99/176 (56.2%) were men. DIC was present in 74/176 (42.05%) patients who had significant prevalence of hemorrhagic syndrome (p = 0.01). Risk factors for overt DIC were: older age (p <0.01), comorbidities (p = 0.01), leukocytosis (p <0.001) and high LDH (p <0.001). FAB type of non-APL AML, cytogenetic risk group, and CD56 had no influence on overt DIC (p> 0.05). No difference was found in early mortality, outcome, and survival of non-APL AML patients with and without DIC (p> 0.05).
Conclusion: Older age at diagnosis, comorbidities, leukocytosis, and high LDH concentrations are found to be the adverse risk factors for overt DIC in non-APL AML patients. If treated promptly with immediate, adequate and intensive use of blood derivates and components, DIC has no negative impact on early mortality, outcome, and survival.
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