Coagulation profile in newly diagnosed T-cell acute lymphoblastic leukemia

Li, Xueying; Zhou, Yile; Zhang, Yi; Huang, Xin; Jian-hu, LI; Wang, Huanping; Zhou, De; Li, Li; Zhu, Lixia; Xie, Mixue; Huang, Xianbo; Xie, Wanzhuo; Lou, Yinjun; Meng, Haitao; Yu, Wenjuan; Tong, Hongyan; Jin, Jie; Ye, Xiu-Jin; Zhu, Hong‐Hu

doi:10.1016/j.thromres.2021.04.013

Cited by 4 publications

(3 citation statements)

References 8 publications

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“…Interestingly, over half of patients presenting with a prolonged PT had significant correlation with leukocytosis. All patients with APL presented with elevated PT (which is consistent with published literature(4), along with most patients with T-cell ALL, which has been reported in adult T-cell patients (5).…”

Section: Discussionsupporting

confidence: 89%

Prolonged Prothrombin Time Does Not Correlate with Clinical Bleeding Symptoms in Newly Diagnosed Pediatric Leukemia Patients

Al-Ghafry,

Haimed,

et al. 2024

Preprint

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Prolonged prothrombin time (PT) and/or activated partial thromboplastin time (aPTT) are frequently seen in newly diagnosed pediatric leukemia patients (NDPLP), which can lead to delayed diagnostic and therapeutic procedures due to concern for bleeding. In this single center retrospective study of NDPLP we analyzed these parameters in 93 patients (aged 1-21 years). None had a personal history of bleeding, but 33.3% had bleeding symptoms within 30 days of presentation, predominantly mucosal bleeding (80.6%) and petechiae (64.5%). Median laboratory values at diagnosis: white blood cell count 15.7, hemoglobin 8.1, platelets 64, PT 13.2, and a PTT 31. Red blood cells were administered in 41.2%, platelets in 52.9%, FFP in 7.8%, and vitamin K in 21.6% based on institutional cut-off values for replacement or clinical symptoms. Prolonged PT was found in 54.8% of patients (factor VII 33.1% (interquartile range [IQR] 19.4-50.5), while aPTT was prolonged in 5.4%. Anemia and thrombocytopenia did not correlate with prolonged PT (p=0.73 and p=0.18 respectively), or prolonged aPTT (p=0.52 and 0.42). Leukocytosis and neutrophilia showed significant correlation with elevated PT (p<0.001 and <0.01 respectively), but not aPTT (p=0.3 and 0.5). Bleeding symptoms upon presentation did not correlate with prolonged PT (p=0.83), prolonged aPTT (p=1) or anemia (p=0.06) but had significant correlation with thrombocytopenia (p=<0.0001) and elevated AST (p=0.05). Therefore, a prolonged PT in NDPLP may not necessitate the reflexive use of blood product replacement in the absence of significant bleeding, which is likely related to leukocytosis than to a true coagulopathy.

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Section: Discussionsupporting

confidence: 89%

Prolonged Prothrombin Time Does Not Correlate with Clinical Bleeding Symptoms in Newly Diagnosed Pediatric Leukemia Patients

Al-Ghafry,

Haimed,

et al. 2024

Preprint

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“…Interestingly, over half of patients presenting with a prolonged PT had significant correlation with leukocytosis. All patients with APL presented with elevated PT (which is consistent with published literature [4]), along with most patients with T-cell ALL, which has been reported in adult T-cell patients [5].…”

Section: Discussionsupporting

confidence: 89%

Prolonged prothrombin time does not correlate with clinical bleeding symptoms in newly diagnosed paediatric leukaemia patients

Al-Ghafry

Haimed

et al. 2023

Blood Coagulation &Amp; Fibrinolysis

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Prolonged prothrombin time (PT) and/or activated partial thromboplastin time (aPTT) are frequently seen in newly diagnosed paediatric leukaemia patients (NDPLP), which can lead to delayed diagnostic and therapeutic procedures due to concern for bleeding. A single-centre retrospective chart review of NDPLP between 2015 and 2018 aged 1-21 years. We analysed 93 NDPLP of whom 33.3% had bleeding symptoms within 30 days of presentation, predominantly mucosal bleeding (80.6%) and petechiae (64.5%). Median laboratory values: white blood cell count 15.7, haemoglobin 8.1, platelets 64, PT 13.2 and a PTT 31. Red blood cells were administered in 41.2%, platelets in 52.9%, fresh frozen plasma in 7.8% and vitamin K in 21.6% of patients. Prolonged PT was found in 54.8% of patients, while aPTT was prolonged in 5.4%. Anaemia and thrombocytopenia did not correlate with prolonged PT (P U 0.73 and P U 0.18, respectively), or prolonged aPTT (P U 0.52 and 0.42). Leukocytosis showed significant correlation with elevated PT (P < 0.001), but not aPTT (P U 0.3). Bleeding symptoms upon presentation did not correlate with prolonged PT (P U 0.83), prolonged aPTT (P U 1) or anaemia (P U 0.06) but had a significant correlation with thrombocytopenia (P< -0.0001).Therefore, a prolonged PT in NDPLP may not necessitate the reflexive use of blood product replacement, in the absence of significant bleeding, which is likely related to leukocytosis than to a true coagulopathy. Blood Coagul Fibrinolysis 34:152-155

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“…This may be one reason why the patient's first platelet infusion was ineffective. Li et al [ 9 ] found that the higher the white blood cell count in patients with leukemia, the more serious the destruction of blood vessel walls. Elevated white blood cells can induce the formation of a thrombus and platelet aggregation.…”

Section: Discussionmentioning

confidence: 99%

First platelet transfusion refractoriness in a patient with acute myelocytic leukemia: A case report

Tu,

Fan,

Shi

et al. 2023

World J Clin Cases

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Time series analysis is a valuable tool in epidemiology that complements the classical epidemiological models in two different ways: Prediction and forecast. Prediction is related to explaining past and current data based on various internal and external influences that may or may not have a causative role. Forecasting is an exploration of the possible future values based on the predictive ability of the model and hypothesized future values of the external and/or internal influences. The time series analysis approach has the advantage of being easier to use (in the cases of more straightforward and linear models such as Auto-Regressive Integrated Moving Average). Still, it is limited in forecasting time, unlike the classical models such as Susceptible-Exposed-Infectious-Removed. Its applicability in forecasting comes from its better accuracy for short-term prediction. In its basic form, it does not assume much theoretical knowledge of the mechanisms of spreading and mutating pathogens or the reaction of people and regulatory structures (governments, companies, etc. ). Instead, it estimates from the data directly. Its predictive ability allows testing hypotheses for different factors that positively or negatively contribute to the pandemic spread; be it school closures, emerging variants, etc. It can be used in mortality or hospital risk estimation from new cases, seroprevalence studies, assessing properties of emerging variants, and estimating excess mortality and its relationship with a pandemic.

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Coagulation profile in newly diagnosed T-cell acute lymphoblastic leukemia

Cited by 4 publications

References 8 publications

Prolonged Prothrombin Time Does Not Correlate with Clinical Bleeding Symptoms in Newly Diagnosed Pediatric Leukemia Patients

Prolonged Prothrombin Time Does Not Correlate with Clinical Bleeding Symptoms in Newly Diagnosed Pediatric Leukemia Patients

Prolonged prothrombin time does not correlate with clinical bleeding symptoms in newly diagnosed paediatric leukaemia patients

First platelet transfusion refractoriness in a patient with acute myelocytic leukemia: A case report

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