Skip to main content

Advertisement

SpringerLink
Log in

Clinical significance of fibrinopeptide A in acute lymphocytic and non-lymphocytic leukaemia

  • Original Article
  • Published:
Blut Aims and scope Submit manuscript

Summary

Fibrinopeptide A (FPA) was systematically investigated in 74 patients with acute leukaemia at different stages of the disease (50 with non-lymphocytic leukaemia, ANLL; 24 with lymphocytic leukaemia, ALL). At diagnosis, 75% of the cases had high FPA levels (86% in ANLL and 54% in ALL) with significantly higher levels in ANLL than in ALL (13.4 vs 4.4 ng/ml; p<0.001). Patients with DIC (20 cases in ANLL and 1 case in ALL) had significantly higher levels (p<0.001). FPA levels were neither correlated with fibrinogen or FDP levels nor with blast cell count. During chemotherapy, median FPA did not show significant changes whereas, at the end of therapy, a return toward normality was generally observed both in ALL and ANLL apart from the group of patients with acute promyelocytic leukaemia. Among the 24 patients who entered post-remission follow-up (13 ANLL and 11 ALL), 10 cases out of the 11 relapsing (6/6 with ANLL and 4/5 with ALL) had increased FPA 1 to 2 months before the ascertainment of the relapse. However, 16% and 9% of the samples obtained on different occasions, respectively from ANLL and ALL cases in maintained first remission, showed FPA above the normal limit. This study demonstrates that subclinical activation of blood coagulation, as indicated by high FPA level, is common both in lymphocytic and non-lymphocytic leukemia and suggests that this phenomenon is related to disease activity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Abraham GE (1977) Handbook of radioimmunoassay. Marcel Dekker, New York, p 87

    Google Scholar 

  2. Alkjaersig N, Fletcher AP (1982) Catabolism and excretion of fibrinopeptide A. Blod 60: 148–156

    Google Scholar 

  3. Al-Mondhiry H (1975) Disseminated Intravascular Coagulation. Experience in a major cancer center. Thromb Diathes Haemorrh 34: 181–193

    Google Scholar 

  4. Arlin AZ, Fried J, Clarkson BD (1978) Therpeutic role of cell kinetics in acute leukemia. Clin Haematol 7: 339–362

    Google Scholar 

  5. Bailey K, Bettelheim FR, Lorand L, Middlebrook WR (1951) Action of thrombin in the clotting of fibrinogen. Nature 167: 233–234

    Google Scholar 

  6. Bauer KA, Rosenberg RD (1984) Thrombin generation in acute promyelocytic leukemia. Blod 64: 791–796

    Google Scholar 

  7. Bennet JM, Catovsky D, Daniel MT et al. (1976) French-American-British (FAB) cooperative group. Proposal for the classification of the acute leukemia. Br J Haematol 33: 451–458

    Google Scholar 

  8. Bennet M, Parker AC, Ludlam CA (1976) Platelet and fibrinogen survival in acute promyelocytic leukemia. Br Med J 908: 565

    Google Scholar 

  9. Bernard J, Weil M, Boiron M, Jacquillat C, Flandrin G, Gemon MF (1973) Acute promyelocytic leukemia: results of treatment by daunorubicin. Blood 41: 489–496

    Google Scholar 

  10. Brakman P, Snyder J, Henderson ES, Astrup T (1970) Blood coagulation and fibrinolysis in acute leukaemia. Br J Haematol 18: 135–145

    Google Scholar 

  11. Champion LAA, Luddy RE, Schwartz AD (1978) Disseminated intravascular coagulation in childhood acute lymphocytic leukemia with poor prognostic features. Cancer 41: 1642–1646

    Google Scholar 

  12. Chorba TL, Orenstein JM, Ney AB et al. (1985) Phenotypic and ultrastructural characterization of a medullary thymocyte acute lymphoblastic leukemia with cellular procoagulant activity. Cancer 55: 675–681

    Google Scholar 

  13. Drapkin RL, Gee TS, Dowling MD et al. (1978) Prophylactic heparin therapy in acute promyelocytic leukemia. Cancer 41: 2484–2490

    Google Scholar 

  14. Eckhardt T, Koch M (1986) Fibrinogen proteolysis in acute myelogenous leukemia (AML). Blut 53: 39–48

    Google Scholar 

  15. Egbring R, Schmidt W, Fuchs G, Havemann K (1977) Demonstration of granulocytic proteases in plasma of patients with acute leukemia and septicemia with coagulation defects. Blood 49: 219–231

    Google Scholar 

  16. Elms MJ, Bunce IH, Bundesen PG, Rylatt DP, Webber AJ, Masci PR, Whitaker AN (1986) Rapid detection of crosslinked fibrin degradation products in plasma using monoclonal antibody-coated latex particles. Am J Clin Pathol 85: 360–364

    Google Scholar 

  17. Falanga A, Alessio MG, Donati MB, Barbui T (1988) A new procoagulant in acute leukemia. Blood 71: 870–875

    Google Scholar 

  18. Garg SK, Niemetz Y (1973) Tissue factor activity of normal and leukemic cells. Blood 42: 729–735

    Google Scholar 

  19. Goualt-Heilmann M, Cherdon E, Sultan C (1975) The procoagulant factor of leukaemic promyelocytes: demonstration of immunologic cross-reactivity with human brain factor. Br J Haematol 30: 151–157

    Google Scholar 

  20. Gralnick HR, Marchesi S, Givelber H (1972) Intravascular coagulation in acute leukemia: clinical and subclinical abnormalities. Blood 40: 709–718

    Google Scholar 

  21. Gralnick HR, Abrell E (1973) Studies of the procoagulant and fibrinolytic activity of promyelocytes in acute promyelocytic leukaemia. Br J Haematol 33: 451–458

    Google Scholar 

  22. Gralnick HR, Tan KH (1974) Acute promyelocytic leukaemia. Hum Pathol 5: 661–673

    Google Scholar 

  23. Gralnick HR, Sultan C (1975) Acute promyelocytic leukaemia: haemorrhagic manifestation and morphologic criteria. Br J Haematol 29: 373–376

    Google Scholar 

  24. Gralnick HR (1981) Cancer cell procoagulant activity. In: Donati MB, Davidson JF, Garattini S (eds) Malignancy and the hemostatic system. Raven Press, New York, pp 57–63

    Google Scholar 

  25. Guarini A, Baccarani M, Corbelli G, Gugliotta L, Tura S (1980) Defibrination in adult acute lymphoblastic leukemia. Report of four cases. Nouv Rev Fr Hematol 22: 115–123

    Google Scholar 

  26. Guarini A, Gugliotta L, Timoncini C et al. (1985) Procoagulant cellular activity and disseminated intravascular coagulation in acute non-lymphoid leukaemia. Scand J Haematol 34: 152–156

    Google Scholar 

  27. Gugliotta L, Viganò S, D'Angelo A, Guarini A, Tura S, Mannucci PM (1984) High fibrinopeptide A (FPA) levels in acute non-lymphocytic leukemia are reduced by heparin administration. Thromb Haemost 52: 301–304

    Google Scholar 

  28. Kahle LH, Avvisati G, Lamping RJ, Moretti T, Mandelli F, ten Cate JW (1985) Turnover of alpha-2-antiplasmin in patients with acute promyelocytic leukemia. Scand J Clin Lab Invest 45 [suppl 178]: 75–80

    Google Scholar 

  29. Leavey RA, Kahn SB, Brodsky I (1970) Disseminated intravascular coagulation — A complication of chemotherapy in acute myelomonocytic leukemia. Cancer 26: 142–145

    Google Scholar 

  30. Myers TJ, Rickles FR, Barb CE, Cronlund M (1981) Fibrinopeptide A in acute leukemia: relationship of activation of blod coagulation to disease activity. Blood 57: 518–525

    Google Scholar 

  31. Nossel HL, Yudelman I, Canfield RE et al. (1974) Measurement of fibrinopeptide A in human blood. J Clin Invest 54: 43–53

    Google Scholar 

  32. Rodeghiero F, Barbui T, Battista R, Chisesi T, Rigoni G, Dini E (1980) Molecular subunits and transamidase activity of factor XIII during disseminated intravascular coagulation in acute leukaemia. Thromb Haemost 43: 6–9

    Google Scholar 

  33. Rodeghiero F, Mannucci PM, Viganò S, Barbui T, Gugliotta L, Cortellaro M, Dini E (1984) Liver dysfunction rather than intravascular coagulation as the main cause of low protein C and antithrombin III in acute leukemia. Blood 63: 965–969

    Google Scholar 

  34. Weitz JI, Landman LS, Crowley KA, Birken S, Morgan FJ (1986) Development of an assay for in vivo human neutrophil elastase activity in patients with α-1-proteinase inhibitor deficiency. J Clin Invest 78: 155–162

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Haematology and Haemophilia and Thrombosis Centre, Italy

    F. Rodeghiero, G. Castaman, S. Castronovo & E. Dini

  2. Department of Clinical Chemistry, San Bortolo Hospital, Vicenza, Italy

    G. Soffiati, R. Quaglio & S. Cortesi

Authors
  1. F. Rodeghiero
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Castaman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. Soffiati
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. Quaglio
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S. Castronovo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S. Cortesi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. E. Dini
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rodeghiero, F., Castaman, G., Soffiati, G. et al. Clinical significance of fibrinopeptide A in acute lymphocytic and non-lymphocytic leukaemia. Blut 59, 177–183 (1989). https://doi.org/10.1007/BF00320064

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00320064

Key words

Search

Navigation