Abstract
Among one hundred three cases of leukemia, fifty-two cases were diagnosed to be associated with disseminated intravascular coagulation (DIC).
The outcome of therapeutic trial with heparin and FOY exerted disappointing one; six cases of thirty-nine heparinized cases came of remission. Five cases out of expired thirty-three ones, in whom aggravating factors such as supervened infection, repeated chemotherapy and rapidly progressive disease process of leukemia were present, were alleviated transiently the severity of DIC. Administration of FOY resulted in transient alleviation of DIC in two out of five cases.
From our clinical experience, it is stressed that it is most important to begin the therapeutic intervention of the process of DIC as early as possible. It may reasonable or at least acceptable to try heparin therapy prophylactically with the initiation of chemotherapy of acute promyelocytic leukemia, acute monocytic leukemia or blastic crisis of chronic myelocytic leukemia which are easily complicated with DIC.
Unsatisfied prognosis of DIC associated with leukenia may otherwise be due to difficulty of diagnosis of DIC, because patients with leukemia per se have low platelet counts. Furthermore, slightly elevated levels of FDP and/or subnormal ATIII values were occasionally observed in cases of leukemia in which development of DIC was highly suspected. Therefore, it is advisable to check the hemostatic indicators and clinical symptoms serially for early detection of DIC and to initiate of DIC promptly, if indicated.
