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The bleeding disorder in acute promyelocytic leukaemia: fibrinolysis due to u‐PA rather than defibrination
Author(s) -
Bennett B.,
Booth N. A.,
Croll A.,
Dawson A. A.
Publication year - 1989
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1989.tb06311.x
Subject(s) - fibrinolysis , medicine , fibrinogen , coagulopathy , immunology , gastroenterology , endocrinology
S ummary . Three consecutive patients with acute promyelocytic leukaemia who presented with severe haemorrhagic syndromes were studied and the findings contrasted with those of two patients with classical defibrination after electroshock or complicated labour. The leukaemic patients showed no depletion of fibrinogen. There was no evidence of disordered thrombin generation by either intrinsic or extrinsic pathway sufficient to account for their haemorrhage. All, however, showed strikingly enhanced fibrinolytic activity, which could have accounted for bleeding. This fibrinolytic disorder was characterized by free u‐PA in the plasma and differed from that seen after classical defibrination, where free t‐PA was observed. U‐PA was found also in malignant promyelocytes, which may be the source of u‐PA activity in the patients' plasma. Bleeding in promyelocytic leukaemia may be primarily a fibrinolytic disorder.