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Reinforcement of Platelets Activity in Patients with Acute Myeloid Leukemia (AML) and Concomitant COVID-19 Infection

Z. Stupakova1, I. Dyagil1, O. Karnabeda2, H. Menzarar3

1State Institution "National Research Center for Radiation Medicine of NAMS of Ukraine", Kyiv, Ukraine, 2Bohomolets National Medical University, Kyiv, Ukraine, 3Cancer Center INNOVACIA, Lyutizh, Kiev Region, Ukraine

Abstract Number: PO134

Meeting: ISTH 2021 Congress

Theme: COVID and Coagulation » COVID and Coagulation, Clinical

Background: The overall incidence of venous thromboembolism (VTE) in AML patients is high despite the thrombocytopenia and prophylaxis. Concomitant COVID-19 infection could may well make it worse.

Aims: The primary endpoint was an evaluation of functional activity of thrombocytes under the COVID-19 influence by measuring platelet count, platelets aggregation in the presence of ristocetin, collagen, adenosine diphosphate (ADP), von Willebrand factor: ristocetin cofactor activity [vWF:RCo] as a link of vascular haemostasis; routine coagulation tests – thrombin time, prothrombin time, APTT, Fibrinogen, Antithrombin III as a link of coagulation haemostasis.

Methods: We include 3 patients (2 males and 1 female) with newly diagnosed AML during induction treatment with concomitant COVID-19 infection and 5 patients with newly diagnosed AML during induction treatment, COVID-19 negative. The emergence of VTE events was assessed by a computed tomography.

Results: Three patients in the study group were experienced fatal VTE – two of them had pulmonary embolism (PE) and one mesenteric venous thrombosis (MVT). There were no VTE events in the control group.
In the comprehensive analysis we observed combined increasing in the rate of platelets aggregation in the presence of ristocetin, collagen and ADP higher than normal rates in three patients in the study group which was associated with VTE of different localisations. In the control group such elevation had not been observed.
We have monitored extremely increased levels of vWF:RCo (217%, 190%, 160%) in three patients in the study group, that soon was associated with fatal PE and MVT.

Conclusions: Based on these preliminary results we wanted to emphasize the pathologic changes in primary hemostasis as a result of COVID-19 infection in patients with AML. COVID-19 triggered activation of the haemostasis system might lead to increased consumption of clotting inhibitors as well as associated with extreme enhanced activation of platelets and need to be looked at in more depth.  

To cite this abstract in AMA style:

Stupakova Z, Dyagil I, Karnabeda O, Menzarar H. Reinforcement of Platelets Activity in Patients with Acute Myeloid Leukemia (AML) and Concomitant COVID-19 Infection [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/reinforcement-of-platelets-activity-in-patients-with-acute-myeloid-leukemia-aml-and-concomitant-covid-19-infection/. Accessed November 30, 2023.

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