Coagulant and fibrinolytic activities in the leukemic cell lysates

We attempted to examine procoagulant activity (PCA), X activator activity (XAA) and plasminogen activator activity (PlgAA) of various leukemic cell lysates: 17 acute myelocytic leukemias (AML), 4 acute promyelocytic leukemias (APL), 9 acute myelomonocytic leukemias (AMMoL), 7 chronic myelocytic leukemias (CML), 4 CML with blastic crisis, 7 T cell acute lymphocytic leukemias (ALL), 8 adult T cell leukemias (ATL), 8 null cell ALL, 6 B cell lymphocytic leukemias. Among those 70 cases, 4 APL, 4 AMMoL and 5 AML were associated with overt disseminated intravascular coagulation (DIC) and 5 T cell ALL, 7 ATL and 2 null cell ALL were associated with hypofibrinogenemia not adapted for DIC. The sample used was the lysate of 10(7) cells. PCA was measured by recalcification time of normal plasma with the cell lysate, XAA and PlgAA was measured by chromogenic substrate. APL and AML, especially those associated with overt DIC, had high PCA, and lymphocytic leukemia generally had low PCA in comparison with normal controls. Total PCA (PCA multiplied by cell count/microliter) was remarkably increased in DIC and mildly increased in ALL with hypofibrinogenemia. The change in XAA and total XAA (XAA multiplied by cell count/microliter) was not remarkable in any leukemia except for T cell ALL and null cell ALL with hypofibrinogenemia. PlgAA was high in lymphocytic leukemias with hypofibrinogenemia, APL and AMMoL with DIC. Total PlgAA (PlgAA multiplied by cell count/microliter) was high especially in T cell ALL and null cell ALL with hypofibrinogenemia. Thus it is probable that PCA is the most important factor causing DIC in myelogenous leukemia and that PlgAA is the most important factor causing hypofibrinogenemia in lymphocytic leukemia. The measurement of these activities in the leukemic cells is valuable in prediction and prevention of the hemostatic disorder in leukemia.