[Blood coagulation changes in children with acute myelogenous leukemia: thrombin effect or proteolysis]

Sequential coagulation tests were carried out in 13 children with acute nonlymphoblastic leukemia (ANLL) treated with the German cooperative protocols BFM 78 and 82. The test program included a PTT, Quick's Prothrombin time, Thrombin time, Fibrinogen (Clauss method and RID), coagulation factors II, V, VII, AT III, antiplasmin, plasminogen and FDP. Severe coagulation changes could be demonstrated in ANLL patients with FAB type M2 (myeloblastic leukemia with maturation) and FAB type M5 (monocytic leukemia). Usually they were found already at the time of diagnosis and improved during induction therapy. A variety of coagulation changes were observed, resembling classical DIC, typical hyperfibrinolysis or atypical proteolysis. It is allowed to question the concept of DIC as the typical coagulation disturbance in children with ANLL.