Elastase Mediated Fibrinolysis in Acute Promyelocytic Leukemia

Erik-Jan D. Oudijk; H. Karel Nieuwenhuis; Rogier Bos; Rob Fijnheer

doi:10.1055/s-0037-1613942

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2000; 83(06): 906-908
DOI: 10.1055/s-0037-1613942

Commentary

Schattauer GmbH

Elastase Mediated Fibrinolysis in Acute Promyelocytic Leukemia

Authors

Erik-Jan D. Oudijk

¹From the Department of Haematology, University Medical Centre, Utrecht, the Netherlands
H. Karel Nieuwenhuis

¹From the Department of Haematology, University Medical Centre, Utrecht, the Netherlands

²The Institute of Biomembranes, Utrecht University, the Netherlands
Rogier Bos

³TNO-Prevention and Health, Leiden, The Netherlands
Rob Fijnheer

¹From the Department of Haematology, University Medical Centre, Utrecht, the Netherlands

Abstract

Summary

The bleeding syndrome of acute promyelocytic leukemia (APL) is complex and consists of disseminated intravascular coagulation (DIC) and hyperfibrinolysis. Elastase, derived from malignant promyelocytes, is believed to mediate the fibrinogeno- and fibrinolysis by aspecific proteolysis. In this study we measured the role of elastase in fifteen patients with APL by using an assay for elastase degraded fibrin(ogen) and the results were compared with those obtained in patients with sepsis induced DIC.

High levels of elastase were observed in sepsis and APL. The levels of fibrinogen and fibrin degradation products were significantly higher in APL patients compared to patients with sepsis induced DIC. Nevertheless, the level of elastase degraded fibrin(ogen) was higher in the sepsis group (635.3 ng/ml, compared to 144.3 ng/ml in APL; p <0.0001). So, the enormous increase in fibrin and fibrinogen degradation products in APL cannot be explained by elastase activity. This study suggests a minor role for elastase mediated proteolysis in the hemorrhagic diathesis in APL patients.

Key words

Acute promyelocytic leukemia - fibrinolysis - coagulation - sepsis - elastase

Full Text

References

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