In a group of 100 unselected patients with disseminated malignancies, marked disturbances in the coagulation and fibrinolytic systems were found. Mean silicone coagulation time was shortened, and fibrinogen levels were markedly elevated. Fibrinolysis activation, as manifested by plasma clot lysis, euglobulin lysis, or the presence of fibrin degradation products, was noted in 9 cases. Mean plasminogen levels were normal. There was a significant elevation of urokinase inhibitor, but other inhibitors of fibrinolysis were normal.
A study of the coagulation mechanism in 34 cases of multiple myeloma has been made. Three patients exhibited the “gelation” phenomena, demonstrated to be due to binding of fibrin monomers by abnormal immunoglobulins. Systematic examination of hemostasis in the remaining cases showed both a thrombotic and a hemorrhagic tendency. Abnormal laboratory parameters of the former were: 1. shortened coagulation time, 2. increased fibrinogen levels, and 3. reduced antiplasmin levels. Hemorrhagic tendency was reflected in such laboratory results as: 1. reduced platelet adhesiveness, 2. prolonged thrombin time, 3. prolonged prothrombin time, and 4. increased fibrinolysis.
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