Abstract
Two cases of leukemia associated with DIC and hypocomplementemia were described. A 42-year-old woman with blastic transformation of chronic myelocytic leukemia was transferred to our hospital for further intensive chemotherapy. Despite of the vigorous chemotherapy, there was no hematological recovery and occasional mild hematemesis was noticed. Serum complement components (C1q, C 3, C 4, C 5, C 3 anaphylatoxin and factor B) declined insidiously with concomitant decrease in plasma protease inhibitors such as anti-thrombin III (ATIII), α2- macroglobulin (α2 M) and inter-α-trypsin inhibitor (IαI). Blood coagulation study also showed abnormal findings corresponding to the changes in complement components and protease inhibitors. On the 112th hospital day she suddenly became oliguric and in shock state and on the 120th hospital day expired.
A 71-year-old man with acute monocytic leukemia was admitted because of pallor, purpura and general malaise. Under the diagnosis of acute DIC he received heparin therapy from the 2nd hospital day. He abruptly died of splenic rupture on the 6th hospital day, though his serum complement components and plasma protease inhibitors increased to nearly normal value transiently.
In both cases, in vivo activation of complement could not be detected by immunoelectrophoretic tecnique. However, it is strongly suggested that complement activation may play a relatively important role in DIC, and thus serial examinations of complement may give a prognostic clue.
