Abstract Number: VPB0940
Meeting: ISTH 2022 Congress
Theme: Venous Thromboembolism » Cancer Associated Thrombosis
Background: Acute leukemia is associated with coagulopathy. Acute myeloid leukemia (AML) and acute lymphocytic leukemia (ALL) have a similar incidence of disseminated intravascular coagulation (DIC, 9-22%) and venous thromboembolism (VTE, 2-13%). Interestingly, acute promyelocytic leukemia (APL), a subtype of AML, has an increased incidence of DIC (60-85%) compared with other types of leukemia. This suggests that there are different mechanisms of coagulopathy among different types of acute leukemia.
Aims: To compare levels of various biomarkers, including extracellular vesicle (EV) tissue factor (TF) activity, phosphatidylserine (PS)+ EVs, citrullinated histone H3 (H3Cit)-DNA complex, active plasminogen activator inhibitor 1 (PAI-1) and tissue plasminogen activator (tPA), in patients with different types of acute leukemia.
Methods: Plasma from 30 APL, 281 non-APL AML, and 78 ALL patients were collected. Levels of D-dimer, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, and complete blood count were obtained from medical records. We measured levels of EVTF activity and H3Cit-DNA complex using in-house assays and PS+ EVs, active PAI-1 and tPA using commercially available assays.
Results: APL patients had significantly higher levels of EVTF activity compared to non-APL AML and ALL patients. In contrast, non-APL AML and ALL patients had higher levels of PS+ EVs compared to APL patients. There was no difference in levels of H3Cit-DNA between the three groups. Non-APL AML patients had the lowest levels of active PAI-1 followed by ALL and then APL patients. Levels of tPA were not different between the three groups.
Conclusion(s): Our results suggest that TF+ EVs contribute to the activation of coagulation cascade in APL. In non-APL AML and ALL patients PS+ EVs may contribute to the hypercoagulable state. Low levels of active PAI-1 in non-APL AML patients suggest that fibrinolysis may be enhanced in these patients.
To cite this abstract in AMA style:
Hisada Y, Archibald S, Bansal K, Dwarampudi S, Mullen A, Bhatia S, Bhatia R, Mackman N, Gangaraju R. Biomarkers of coagulopathy in patients with different types of acute leukemia [abstract]. https://abstracts.isth.org/abstract/biomarkers-of-coagulopathy-in-patients-with-different-types-of-acute-leukemia/. Accessed March 22, 2024.« Back to ISTH 2022 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/biomarkers-of-coagulopathy-in-patients-with-different-types-of-acute-leukemia/