The influence of induction chemotherapy and remission status on haemostasis in patients treated for acute myeloid leukaemia

: Haemostatic parameters were studied in 31 adult patients treated for acute myeloid leukaemia (AML) using the 3 + 7 regimen. Lower values of antithrombin III (AT-III), alpha 2-antiplasmin (alpha 2AP) and plasminogen were observed on days 8 and 14 (P < 0.05). Fibrinopeptide A (FpA) levels were higher at diagnosis (P < 0.05), increased again during chemotherapy on days 4 and 8 and eventually returned to the normal range. Tissue plasminogen activator, plasminogen activator inhibitor, protein C and fibrin(ogen) degradation products were normal throughout the period of observation. Complete remission (CR) was achieved in 19 of 31 patients (61%). In order to compare haemostatic changes in CR patients with those in refractory cases, patients were divided into two groups. In patients with refractory AML (n = 12) AT-III, plasminogen and alpha 2 AP were significantly lower than in those in CR. FpA levels were increased in all patients at diagnosis. This elevation progressed in both groups during chemotherapy (on days 4 and 8) and then normalized only in patients in CR. However, in resistant patients, higher FpA values persisted or even increased further on day 14. The fact that none of our patients suffered from clinically manifest thrombotic complications suggested that haemostasis was well compensated and the observed changes were of no clinical importance, even if they were significant statistically.