الفهرس 
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Abstract
In this work, studies have been directed to the elements of the haemostatic system in a trial to detect any possible changes that might explain the haemostatic imbalance in leukaemia, especially acute leukaemias. Forty seven patients with acute leukaemia were subjected to study: 9 were AUL, and 38 were ALL cases in addition to seven patients with chronic leukaemia of which two cases were CLL and five were CLL. Blood samples were taken right after diagnosis was established and prior to the start of chemotherapy.
from the results of the haemogram, anaemia was found in all AML cases; 26 out of 38 ALL cases; in the two cases of CLL and 2 out of 5 CML cases. In the 9 AUL cases, leucocytosis was observed in 7 cases and leucopenia in 2 cases. In the 38 ALL cases, leucocytosis was observed in 18 cases; leucopenia in 7 cases and hyperleucocytosis in 8 cases. The letters showed some correlation with bad prognosis (P<0. 01). In chronic leukaemias hyperleucocytosis (>100.000/mm3) was only observed in 3 of the CML cases. Study of the haemostatic functions revealed the following observations:
1) Platelet count was reduced in 36 out of 38 ALL cases; in 8 out of 9 AML cases (P <0.05) and in only one case out of 5 CML cases.
2)Prothrombin time (P.T.) showed prolongation in 5 out of 9 AML cases; in 23 out of 38 ALL cases (P <0.05) and in 2 out of 5 CML cases.
3)Partialmthromboplastin time (PTTK) showed abnormality in 22 out of 38 ALL. It was prolonged’in 21 cases (P<0.05) and shortened in one. Prolonged PTTK was found in 5 out of 9 AML cases (P4:0.05). One out of 5 CML cases showed prolonged PTTK and one had shortened PTTK.
4)Plasma fibrinogen level determined by the usual clotting method was abnormal in 5 out of 9 An cases (P4:0.05); 4 cases had decreased levels and one case showed increased level. In ALL cases abnormal levels were found in 25 out of 38 cases (P4:0.05); it was decreased in 24 cases and increased in one case. In chronic leukaemia, one out of 2 CLL cases showed increased level and 2 out of 5 CML cases showed non significant decreased level. When combining results of the clotting method with those of the immunological technique, dysfibrinogenaemia was only detected in two cases with AL.
5)Antithrombin III was low in 2 out of 9AML cases and in 10 out of 38 ALL cases (P <0.05). In chronic leukaemias, it was non significantly low in 2 out of
5 CML cases. No significant correlation between fibrinogen and P.T., PTTK and AT III was observed.
6) Coagulation factors VII-X percent concentration was significantly low in 24 out of 38 ALL cases and in
3 out of 9 AML cases (F<0.05). In chronic leukaemias, non significant low EVII-X concentration was found in 3, out of 5 CML cases. Significant correlation between P.T. and F VII—X concentration was found in all cases.
DlC was detected in 23 out of 38 ALL cases; 3 out of 9 AYL cases and in only one out of 5 CML cases. from the results obtained for the present study one can conclude that coagulopathy in leukaemia could be attributed to:
• Reduced platelet count which plays a prominent role as part of consumptive coagulopathy.
• DIC which is a common finding in our ALL cases than AML cases. This could be attributed to the predominence of the bad prognostic ALL (L2) subtype in the Egyptian population.
• Coagulation factors ”fibrinogen and F VII-X” defects which could be explained as increased consumption due to the presence of DIC.
Dyefibrinogenaemia which was detected by combining the results of the clotting and immunological fibrinogen assay techniques in only two Al cases.
In acute leukaemia cases the most affected parameters in the order of frequency were:
1)Platelet count.
2)Fibrinogen level.
3)P.P.
4)Coagulation factors VI’S.
5)PTTK.
6)AT III.
In chronic leukaemia cases:
1)Coagulation factors VII Y.
2)P.P., PTTK, AT III and fibrinogen were equally affected.
3)Platelet count.