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. 2022 Jul 13:2022:7828230.
doi: 10.1155/2022/7828230. eCollection 2022.

Analysis of Risk Factors of Coagulation Dysfunction and Hemorrhage in Newly Diagnosed Hyperleukocytic Acute Myeloma Leukemia

Anjie Xu  1 , Pan Liu  2 , Fuling Zhou  3
Affiliations

Analysis of Risk Factors of Coagulation Dysfunction and Hemorrhage in Newly Diagnosed Hyperleukocytic Acute Myeloma Leukemia

Anjie Xu et al. Contrast Media Mol Imaging. .

Abstract

Purpose: To explore whether and why abnormal coagulation function and hemorrhage can appear in patients with hyperleukocytic acute myeloid leukemia (HAML).

Method: We retrospectively reviewed the charts of 724 acute myeloid leukemia (AML) patients admitted with a white blood cell count of >100 × 109/L between 2010 and 2019 in order to analyze the coagulation index of patients with HAML and explore the correlation of abnormal coagulation.

Result: Prothrombin time (PT) was extended in group HAML compared with group non-HAML. Respiratory failure, intracranial hemorrhage, and infection were more common in the HAML group. Among the 76 HAML patients, there were 33 patients who had ≥3 abnormal items of coagulation index, and 51.5% of them had level 2 hemorrhage which was more than level 0 hemorrhage, and the difference is statistically significant (P < 0.01). Similarly, we can discover that 40.9% of patients with 2 abnormal items had level 2 hemorrhage in contrast to 0 abnormal items. The use of hydroxyurea had a significant effect on PT and D-dimer (DD). Survival analysis by the Kaplan-Meier method showed that there were statistically significant differences in white blood cell (WBC) count＞200 × 109//L and DD. Abnormal PT is associated with WBC count＞200 × 109//L, and abnormal activated partial thromboplastin time (APTT) is associated with HLA-DR mutation. Infection and respiratory failure were independent influencing factors for the coagulation of patients.

Conclusion: DD had a marked effect on the survival rate. Infection and respiratory failure were independent influencing factors for the coagulation of patients.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Time curve of coagulation function of patients with HAML. PT: prothrombin time; FIB: the fibrinogen; APTT: activated partial thromboplastin time; DD: D-dimer.
Figure 2
Figure 2
K-M survival curve of patients with hyperleukocytosis. WBC: white blood cell; DD: D-dimer; P values were calculated using the univariate proportional-hazard model.
Figure 3
Figure 3
Coagulation function of HAML patients with infection (a) and respiratory failure (b) RF: respiratory failure.
See this image and copyright information in PMC

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