The Detection And Clinical Implications Of Membranal TF Expression On Leukemic Blasts And Plasma F1+2 In Patients With Acute Leukemia At Presentation

ObjectiveTo observe the extent of tissue factor (TF) expression on leukemic blasts surface, plasma level of prothrombin fragment 1+2 (F1+2) in patients with various subtypes of acute leukemia (AL) at presentation; to compare the levels of above-mentioned indicators between complicated DIC subgroups and subgroups without DIC, and establish their correlations between TF expressional extent and plasma Fl+2 level, investigating the significance of the parameters for predication and diagnostic assessment of disseminated intravascular coagulation (DIC) concomitant with AL, and predicting the potentiality and severity of DIC concomitant with leukemia.MethodsExpressional extent of TF was assayed by flow cytometry (FCM) on membranous surface of mononuclear cells (MNCs) freshly isolated from bone marrow in 50 consecutive AL patients at diagnosis and 12 "normal" controls. Concentration of plasma F1+2 was detected by enzyme-linked immunosorbent assay (ELISA).ResultsExpressional extent of membranal TF on leukemic blasts surface in acute myelogenous leukemia (AML)-M3 (mean 48.23%) was higher than that in AML-M_1-2, M₄ and ALL (p < 0.01, < 0.05 and < 0.01, respectively), having no statistical significance with AML-M5 (mean 40.51%). Plasma F1+2 level in AML-M₃, M₄ and M₅ was significantly elevated as compared to normal controls (0.72±0.35 nmol/L) (p< 0.05). No expression was found on granulocytes-monocytes populations. TF expressional extent and plasma Fl+2 level in complicated DIC subgroups were both significantly higher compared with subgroups without DIC (p<0.005 and p<0.01, respectively). Correlation was taken on in TF expressional extent and plasma Fl+2 level (r=0.682,p<0.001).ConclusionsAL at presentation presents with coagulation activation, manifested by increased TF expression on leukemic blasts membrane and subsequently raised production of thrombin, as is noticing particularly in AML-M₃ and M₅. TF expressional extent on membrane assayed by FCM may provide to some extent predictive and suggestive implications for the potentiality of DIC concomitant with AL.