Evaluation of plasma activity level of anticoagulant proteins in patients with acute lymphoblastic leukemia in Shafa hospital Ahwaz 2010.

BACKGROUND AND OBJECTIVES Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy as associated with various coagulation abnormalities such as hemorrhage and thrombosis. This study was designed to investigate the distribution pattern of plasma activity level of anticoagulant protein such as proteins C and S, antithrombin, activated protein C resistance (APCR-V) and D-dimer in patients with ALL. PATIENTS AND METHODS We studied thirty patients with confirmed ALL admitted in Shafa Hospital Hematology-Oncology and Thalassemia-Hemoglobinopathy Research Center and thirty normal (age and sex matched) subjects as control group. Proteins C and S, antithrombin, APCR-V were measured by coagulation analyzer and D-dimer analysed with Asserachrom D-Di enzyme immunoassay kit in patients and control group. RESULTS The mean activity levels of protein C (p = 0.017) and antithrombin (p = 0.014) were significantly lower in patient to group compared to the control group. However, the patient group had significantly elevated mean levels of protein S (p = 0.004) and D-dimer (p = 0.0001) compared to the control grup. About 3% of patients had APCR-V. There was no significant difference in APCR-V found between patient and control group (p = 0.674). CONCLUSIONS The hypercoagulability in ALL patients may attribute to the low levels of protein C and antithrombin and the high level of protein S and D-dimer. According to our findings, the use of suitable anticoagulant therapy as a prophylactic measure can be proposed.