Blood Coagulation and Fibrinolysis in Acute Leukaemia

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Abstract
Summary. Selected parameters of blood coagulation and fibrinolysis were determined in blood plasma both from 26 patients with untreated acute leukaemia and from patients in remission. Normal, as well as unusually low or high, levels of fibrinogen were observed in the untreated group. Factor VIII was consistently increased in the active state of the disease and remained elevated in patients in long‐term remission. Plasminogen was low in six untreated patients, five of whom died soon after admission. The plasma euglobulin fibrinolytic activity showed wide variations with an increased average value, though four untreated patients (and three patients in long‐term remission) had unusually low activities. In the untreated group fibrinolytic activity of the ‘peptone’ precipitable euglobulins was usually lower than in regular euglobulin precipitates, a reversal of the pattern observed in normal persons. Inhibition of fibrinolysis was decreased in a few patients. There was no consistent relation between occurrence of bleeding episodes and defects in coagulation or fibrinolysis. This, taken together with the variability of the data, would suggest that haemorrhage in acute leukaemia is the result of a fortuitous combination of haemostatic defects. Determinations of factor V and plasminogen may be of prognostic value.

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