DISSEMINATED INTRAVASCULAR COAGULATION IN ACUTE LEUKEMIAS AT FIRST DIAGNOSIS

Haemorrhagic diathesis is the commonest cause of morbidity and mortali ty in acute leukaemias (AL). It is most commonly due to thrombocytopen ia resulting from bone marrow failure. However, in a significant numbe r of cases, disseminated intravascular coagulation (DIC) plays an impo rtant part. Previously it was thought that this mechanism was mainly c onfined to acute promyelocytic leukaemia (APL), but recently it has al so been reported to occur in other subtypes of acute leukaemia. We rep ort the results of a study carried out to find the incidence of DIC in Various types of AL at the time of first diagnosis and in the absence of other recognisable causes. DIC was observed in 14(13.4%) cases out of 104 cases of AL studied. Nine out of 49(18.4%) cases of AML and 5 out of 55(9.1%) cases of acute lymphoblastic leukaemia (ALL) showed co agulation abnormalities consistent with DIG. Out of the 9 cases of AML showing DIG, 63 (66.67%) belonged to APL (FAB ME) subtype. Three (60% ) out of 5 cases of ALL with DIC had T-cell immunophenotype. The resul ts indicate that DIC may also occur in types of AL other than APL, par ticularly in T-ALL, and should be looked for.