AML-320 Some Hemostatic Parameters in Sudanese Acute Myeloid Leukemia Patients

• Published in: Clinical lymphoma, myeloma and leukemia Vol. 23; p. S289
• Main Authors: Alkhair, Emaduldin M., Hafize, Hussam, Elbager, Sahar G., Babiker, Shazalia K.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-09-2023
• Subjects: Acute myeloid leukemia; APTTT; FAB; fibrinogen) hemorrhage; hemostatic parameters (PT; Sudan; hemostatic parameters (PT; APTTT; fibrinogen) hemorrhage; Acute myeloid leukemia; FAB; Sudan
• ISSN: 2152-2650; 2152-2669
• DOI: 10.1016/S2152-2650(23)01038-8

Acute myeloid leukemia (AML) is a malignant disease characterized by clonal expansion of myeloid progenitors (blasts) in the bone marrow and peripheral blood. Patients with AML recurrently develop thrombohemorrhagic disorders that complicate the management of these patients and can lead to treatment failure and significant morbidity and mortality.
To evaluate the activated partial thromboplastin time (APTT), prothrombin time (PT), and plasma fibrinogen levels, and their correlation with FAB subtype in Sudanese patients with AML.
This cross-sectional study was conducted at Khartoum oncology hospital, Sudan, from June to November 2021. A total of 50 AML patients (who met inclusion criteria) and 50 healthy individuals as controls were included in this study. APTT and PT were measured using a clot-based assay, and plasma fibrinogen level was measured using the Clauss method.
Out of 50 AML patients, there were 24 females and 26 males with mean age 31.4±6.0 years. The majority of the patients were seen in the 16 to 30-year age group. Based on FAB classification, AML- M0, M1, M2, M3 and M4 subtypes were seen in 11, 12, 16, 6, and 5 patients, respectively. None of the patients belonged to AML-M5, M6 and M7 subtypes. AML patients had significant prolonged APTT and PT compared to the control subjects (39.6±1.3s vs 30.5±3.4s; P=0.000) and (19.3±2.1s vs 13.6±1.1s; P=0.000) respectively, while no significant difference in mean fibrinogen levels (2.6±0.4g/l vs 2.4±0.7g/l; P=0.05). Among AML subtypes, AML-M3 patients had slightly prolonged APTT (40.8±1.7s) and prolonged PT (20.0 ±2.2s) compared to other subtypes, although the difference was statistically insignificant (P>0.05). Similarly, the difference in mean plasma fibrinogen levels was statistically insignificant between the AML subtypes (P>0.05).
This data indicated that the Sudanese patients with AML had significant prolonged APTT and PT values. PT is a significant prognostic risk factor for early death in patients with AML. Screening tests of APTT and PT should be performed in AML patients, which might give the clinician more meaningful prognostic information reflected in the optimal therapeutic management decision.