Diagnosis of pre-disseminated intravascular coagulation by hemostatic molecular markers in acute leukemic patients

Objective To study the changes of hemostatic molecular markers in acute leukemia(AL) patients, for elucidating their significance on diagnosis of pre disseminated intravascular coagulation(pre DIC). Methods A number of hemostatic molecular markers, including TAT、TF、TFPI、PAP and D D were measured by ELISA methods in 81 acute leukemia patients. Results Plasma levels of TAT、TF、PAP、D D were significantly higher than in those without patients, while PAP level was markedly elevated in APL patients with pre DIC. The sensitivity of TAT、PAP and D D for the diagnosis of pre DIC were 88.5% 、97.14%、85.75, whereas the specificity were 69.57%、 76.09% and 89.13%. By combination of the results of TAT、PAP and D D, the sensitivity was 80% and the specificity was 95.56%. Plasma levels of TF remained at high levels in patients who developed DIC. Conclusion The hemostatic molecular markers TAT、PAP and D D were useful for the diagnosis of pre DIC, while combinations of hemostatic molecular markers increase the specificity of its diagnosis. TF is an important marker to predict the development and prognosis of DIC. TAT/PAP ratio may be helpful in the proper management of patients with DIC and during the use of antithrombin and/or antifibrinolytic agents.