PB1778 ESTIMATION OF PROTEIN Z LEVEL IN ADULT NAÏVE ACUTE MYELOID LEUKEMIA PATIENTS

Background: The occurrence of various coagulation abnormalities in acute leukemia is well established, but there are no data assessing the role of protein Z (PZ), a vitamin K‐dependent plasma protein in hemostatic disorder in hematology cancers, including acute leukemia, The potential role of alterations of PZ levels in the pathogenesis of disorders of coagulation has been investigated and revealed conflicting results as Protein Z (PZ) deficiency may induce bleeding as well as thrombosis. Aims: to estimate the level of protein Z in Acute Myeloid Leukemia (AML) patients and its correlation with bleeding tendency or thrombosis Methods: PZ level was measured by ELISA kits in 60 adult naïve (AML) patients aged above 16 years old and 30 healthy controls after informed consent from Clinical Hematology Unit, Ain‐Shams University Hospital and correlated it with bleeding and thrombotic episodes. Patient on oral anti‐coagulant regularly, Inherited bleeding disorder, Inherited thrombophilia were excluded. Results: The median PZ level was lower in AML Patients in comparison to healthy controls{205ng/L (150 – 340) vs 349.5ng/L (274 – 400) with p value   <   0.001 }. No statistically significance correlation between protein Z level with initial platelet count (P value 0.323). A statistically significant correlation was detected between episodes of bleeding and PZ level (P value 0.008) . By utilizing ROC curve, the best cutoff value for protein Z as a predictor for bleeding episodes during induction was found >350ng/L. Summary/Conclusion: Conclusion: The results suggest that PZ level was lower in AML patients than healthy control and it was correlated with bleeding episodes. can be a cofactor associated with an increased bleeding tendency in AML patients. Summary: PZ can be a cofactor associated with an increased bleeding tendency in AML patients.