DISSEMINATED INTRAVASCULAR COAGULATION (DIC) IN ADULT PATIENTS WITH ACUTE-LEUKEMIA

In 71 patients with acute leukaemia admitted for remission induction, disseminated intravascular coagulation (DIG) was looked for in 50 pati ents and diagnosed in 10 (20%). Of 10 patients with acute lymphoblasti c leukaemia, 3 had DIG, and of 40 patients with acute myeloblastic leu kaemia, 7 had DIG. The presence of DIC was related to bleeding manifes tations within the first 2 weeks. A haemorrhagic diathesis was present in all DIC patients: 4 had minor and 6 had major bleeding, i.e. WHO g rade greater than or equal to 2. In addition to blood product support, most DIC patients were treated with low doses of heparin and tranexam ic acid. In all DIC patients the haemorrhagic symptoms preceded the he parin administration. Among 40 screened patients without DIG, 17 patie nts had minor and 3 had major haemorrhagic manifestations. Thus, the p roportion of patients with major bleeding was significantly greater am ong the DIC patients (6/10 vs 3/40, p < 0.001). In conclusion, DIC at presentation was associated with a significantly increased risk for se vere haemorrhagic complications and should be looked for in adults wit h acute leukaemia.