Erschienen in:
01.03.2013 | Original Paper
International Society of Thrombosis and Hemostasis Scoring System for disseminated intravascular coagulation ≥6: a new predictor of hemorrhagic early death in acute promyelocytic leukemia
verfasst von:
Mirjana Mitrovic, Nada Suvajdzic, Andrija Bogdanovic, Nada Kraguljac Kurtovic, Aleksandra Sretenovic, Ivo Elezovic, Dragica Tomin
Erschienen in:
Medical Oncology
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Ausgabe 1/2013
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Abstract
High-hemorrhagic early death (ED) rate is a major impediment in the managing of acute promyelocytic leukemia (APL). In our group of 56 newly diagnosed APL patients, ED occurred in 12 subjects, due to endocranial bleeding (8/12), differentiation syndrome (2/12), or infection (2/12). Predictors of hemorrhagic ED were as follows: white blood cells count ≥20 × 109/L (P = 0.002337), Eastern cooperative oncology group performance status ≥3 (P = 0.00173), fibrinogen level <2 g/L (P = 0.004907), prothrombin time <50% (P = 0.0124), and International Society of Thrombosis and Hemostasis Scoring System for disseminated intravascular coagulation (ISTH DIC score) ≥6 (P = 0.00741). Multivariate analysis indicated ISTH DIC score ≥6 to be the most significant predictor for hemorrhagic ED (P = 0.008). The main finding of this study is that simple coagulation-related tests, performed on hospital admission and combined in the ISTH DIC score, might help to identify patients at high risk for fatal bleeding needing more aggressive supportive measures.