Defibrination in adult acute lymphoblastic leukaemia. Report of four cases

Defibrination is a rare event in acute lymphoblastic leukaemia (ALL). This paper describes four cases of acute defibrination in a series of 52 adult patients with ALL. All four patients had blood clotting tests consistent with or suggesting defibrination prior to therapy, but haemorrhages and unequivocal laboratory evidence of defibrination developed only after leukaemic blast cells had been destroyed early during therapy for remission induction. All patients received supportive therapy, and three of them were also given a continuous IV heparin infusion. Haemorrhages were controlled and blood clotting tests were improved within 12--48 h.