HEMOSTATIC AND FIBRINOLYTIC PARAMETERS IN SEPTIC PATIENTS WITH LEUKOPENIA OR LEUKOCYTOSIS

Induction of leukocytopenia by cytotoxic drugs protects against the ge neralized Shwartzman reaction induced by endotoxin. To elucidate the r elationship between leukocyte number and in haemostatic and fibrinolyt ic disturbances in human sepsis, we studied 32 septic patients with ab normal leukocyte counts. Twenty patients had sepsis in the setting of leukopenia after chemotherapy for haematological malignancies. Twelve patients with leukocytosis developed sepsis associated with benign dis orders. Concentrations of thrombin-antithrombin III complex (TAT), pla sminogen activator inhibitor-1 (PAI-1) and plasma thrombomodulin (TM) in the leukocytosis group of (12.0 +/- 11.0, 40.2 +/- 27.0 and 5.5 +/- 2.3 ng/ml, respectively) were significantly elevated compared to the leukopenia group of (3.8 +/- 2.3, 18.0 +/- 15.0 and 3.1 +/- 1.0 ng/ml, respectively) and controls (3.3 +/- 0.4, 10.5 +/- 5.3, 3.0 +/- 0.5 ng /ml, respectively). On the other hand, there were no significant diffe rences in these values between leukopenia group and controls. Thus leu cocytes may play important roles in thrombin generation, PAI-1 release and injury to endothelial cells.