HYPOFIBRINOGENEMIA IN NON-M3 ACUTE MYELOID-LEUKEMIA - INCIDENCE, CLINICAL AND LABORATORY CHARACTERISTICS AND PROGNOSIS

Among 379 patients with AML with FAB type MI, 2 and M4-7 diagnosed bet ween 1978 and 1997 in our institution, 19 (5%) had hypofibrinogenemia (HF), ie a fibrinogen level < 180 mg/dl. Compared to patients with nor mal fibrinogen (n = 360) patients with HF had significantly elevated m arkers of activation of coagulation (TAT, F1.2, FPA) and fibrinolysis (D-dimer, FDP) indicating that disseminated intravascular coagulation/ hyperfibrinolysis was the cause of hypofibrinogenemia. Patients with H F had significantly longer prothrombin times, thrombin clotting and re ptilase times. Factor X and VIII were significantly lower than in pati ents without HF. With the exception of M7, HF occurred in all FAB subt ypes, but was most common in M5 (12.1%). Patients with HF did not diff er from those with normal fibrinogen with regard to age, sex, leukocyt e count and other hematological parameters. During induction chemother apy fibrinogen normalized rapidly (median 5 days) and there was no inc reased incidence of early hemorrhagic death. The overall and disease-f ree survival was similar to that of patients without HF.