Activation of coagulation system and d-dimer levels in children with acute leukemia
Journal Title: Paediatrica Indonesiana - Year 2014, Vol 54, Issue 4
Abstract
Background D-dimer is a molecule as result of breaking downof excessive fibrin formation from the activation of coagulationsystem. There is evidence of increased activation of coagulation inpatients with acute leukemia which was showed by the incrementof d-dimer levels.Objective To evaluate the incidence of activation of coagulationsys tem in children with acute leukemia before receivingchemotherapy.Method This cross-sectional study was performed at Dr. CiptoMangunkusumo Hospital. All newly-diagnosed children with acuteleukemia were included in this study, prior to their receiving anychemotherapy treatment. Blast count, prothrombin time (PTI),activated partial thromboplastin time (APTf), and D-dimer levelswere examined after the diagnosis was confirmed by morphology andimmunophenotyping studies on bone marrow specimens.Results Out of 22 subjects, 13 subjects had increased D-dimervalues. The median D-dimer level of this elevated group was 1,000(range 500-14, 700) n gfmL. In the acute myeloblastic leukemia(AML) patients, activation of coagulation was found in 7 out of 8subjects. The median D-dimer levels was 950 (range 100-14, 700)ng/mL. In the acute lymphocytic leukemia (ALL) patients, 6 outof 14 subjects had increased activation of coagulation with medianD-dimer level of 300 (range 100-3,800) ngfmL. Nine out of 10subjects with blast cells on peripheral blood smear had a medianD-dimer level of 1,000 (range 500-3,800) ng/mL. Both PT andAPTT were found normal in all subjects.Conclusion Activation of coagulation sys tem occurs at thetime of diagnosis as shown by increased D-dimer levels. Thecharacteristics of activation of coagulation system are differentbetween ALL and AML subjects, as well as between subj ects withpositive and negative blast counts on peripheral blood smears.Despite the increased activation of coagulation, PT and APTfremain normal.
Authors and Affiliations
Harun Wijaya, Novie Chozie, Badriul Hegar
Keywords
Related Articles
- EP ID EP458734
- DOI 10.14238/pi54.4.2014.227-31
- Views 86
- Downloads 0
The relationship between thrombocytopenia and intraventricular hemorrhage in neonates with gestational age <35 weeks
Background The prevalence of thrombocytopenia in neonates ranges from 22 to 35%, and one of the most feared complications is intraventricular hemorrhage (IVH). Previous research in Cipto Mangunkusumo Hospital (CMH), Jak...
Management of Lowe syndrome: a case report
Lowe syndrome (the oculocerebrorenal syndrome of Lowe, OCRL) is a multisystem disorder characterized by anomalies affecting the eyes, nervous system and kidneys.1-3 The disorder was first recognized by Lowe et al. in 195...
Low serum zinc and short stature in children
Background Short stature/stunting is common in developing countries, and has been used as an indicator of a nation’s general health condition. Short stature increases the risk of metabolic disease, disturbances in cognit...
Immunotherapy and probiotic treatment for allergic rhinitis in children
Background Allergic rhinitis is a global health problem that is increasing in prevalence. Many kinds of therapy have been tried, such as antihistamines, probiotics, and immunotherapy. Immunotherapy may restore the patien...
Risk of nutritional status on diarrhea among under five children
Background Diarrhea is still the leading cause of children’s mortality worldwide and the main cause of malnutrition. Meanwhile, malnourished children are proven to have more severe, prolonged, and frequent episodes of di...