Coagulation aberrations in adult patients with acute leukemia: A single center experience

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Background and objective: Acute leukemia (AL) patients are at high risk for bleeding and thrombotic events due to the disruption of the normal hemostatic system associated with this disease. As a result of the lack of data on coagulopathy in AL patients in our locality, we conducted this study to assess the hemostatic parameters in patients with newly diagnosed AL at the time of presentation. Methods: This prospective cross-sectional study included 59 patients with de novo AL, along with 35healthy control subjects. The study was conducted at Nanakali Hemato-Oncology Center between September 2021 and May 2022. Coagulation markers, including prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen levels (FBG), D-dimer (D-Di), antithrombin (AT), protein C (PC), and protein S (PS) were measured for each patient and control. Results: The median age of the patients was 41 years, with a male to female ratio of 1.1:1. Thirty-eight (64.4%) patients had acute myeloid leukemia (AML) and 21 (35.6%) patients had acute lymphoblastic leukemia (ALL). D-Dilevels were significantly raised in both AML and ALL compared to controls. PT was significantly higher, and PC and AT were significantly lower in AML compared to ALL or control groups. The Bleeding incidence in AML was significantly higher than in ALL (65.8% versus 23.8%). Thrombosis occurred in two (3.4%) patients. Conclusion: Coagulation abnormalities were common in AL. The hemostatic derangement and bleeding at the time of presentation were more pronounced in patients with AML than in ALL.