The frequency of disseminated intravascular coagulopathy in newly diagnosed adult patients with haematological malignancies attending Nanakaly Hospital in Erbil

  • Reving Rebar Akram Department of Community Nursing, College of Nursing, Hawler Medical University, Erbil, Iraq.
  • Kawa Muhammedamin Hassan Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq.
Keywords: Knowledge, Attitudes, Practice, Family Planning

Abstract

Background and objective: Disseminated intravascular coagulation significantly contributes to the bleeding and thrombotic complications in patients with haematologic malignancies. This study was conducted to find out the incidence of disseminated intravascular coagulopathy in haematological malignancies before introduction of chemotherapy.

Methods: A prospective case series study was performed at Nanakaly Hospital for Blood Diseases from April 30, 2011 to April 1, 2012. Seventy patients with different haematological malignancies were enrolled; they were assessed with clinical importance of global haemostatic laboratory tests.

Results: Eighteen percent of studied patients had overt disseminated intravascular coagulopathy. The haemostatic measures were higher in overt disseminated intravascular coagulopathy cases than those with no evidence of disseminated intravascular coagulopathy cases (P < 0.001); and the highest incidence of disseminated intravascular coagulopathy cases was in acute promyelocytic leukemia's patients (77%, P = 039). Most of disseminated intravascular coagulopathy cases were clinically manifested with anemia, bleeding and rarely with thrombosis (100%, 69% and 7%, respectively).

Conclusion: Disseminated intravascular coagulopathy is not uncommon in haematological malignancies before starting chemotherapy. Global haemostatic tests are helpful for diagnosis of disseminated intravascular coagulopathy side by side with clinical manifestations and medical history.

References

Hoffman R. Haematology, Basic Principles and Practice. 5th ed. Netherlands: Elsevier; 2011.

Franchini M, Di Minno M. DIC in Haematological Malignancies. Semin Thromb Hemost 2010; 36:388–403.

Gomez K, Tuddenham E, McVey J. Normal Haemostasis. In: Hoffbrand A, Catovsky D, Green A. Postgraduate Haematology. 6th ed. New Jersey: Wiley-Blackwell; 2011.

Manning R, Laffan M A. Investigation of haemostasis. In: Bain B J, Bates I, Laffan M A. Dacie and Lewis Practical Haematology. 11th ed. Netherlands: Elsevier; 2011.P. 409-10.

Dixit A, Chatterjee T, Mishra P, Kannan M. Disseminated Intravascular Coagulation in Acute Leukemia at Presentation and During Induction Therapy. Clin Appl Thromb Hemost 2007; 13: 292.

Nur S, Anwar M, Saleem M, Ahmad PA. DIC in acute leukaemias at first diagnosis. Eur J Haematol 1995; 55: 78-82.

Rodgers G. Acquired Coagulation Disorders. In: John P G, John F. Wintrobe’s Clinical Haematology. 12th ed. Philadelphia: Lippincott Williams & Wilkins; 2009. P. 1430-1.

Higuchi T, Toyama D, Hirota Y. DIC complicating acute lymphoblastic leukemia: A study of childhood and adult cases. Leuk Lymphoma 2005; 46(8): 1169 – 76.

Levi M, Toh CH, Thachil J, Watson HG. Guidelines for the diagnosis and management of disseminated intravascular coagulation. Br J Haematol 2009; 145 (1): 24–33.

Taylor FB, Toh CH, Hoots WK, Wada H, Levi M. Scientific Subcommittee on DIC of the ISTH, Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. Thromb Haemost 2001; 86(5):1327-30.

Collins P, Thachi J, Toh C. Acquired Coagulation Disorders. In: Hoffbrand A, Catovsky D, Green A. Postgraduate Haematology. 6th ed. New Jersey: Wiley-Blackwell; 2011.

Iba T, Asakura H. Comparison between British and Japanese guidelines for the diagnosis and treatment of DIC. Br J Haematol 2010; 149:451-62.

Toh C, Hoots W. The scoring system of the Scientific and Standardization Committee on DIC of the ISTH: a 5-year overview. Thromb Haemost 2006; 5: 604-6.

Bakhtiari K, Meijers JC, de Jonge E, Levi M. Prospective validation of the ISTH scoring system for DIC. Crit Care Med. 2004; 32(12):2416-21.

Wada H, Sakuragawa N. Are fibrin-related markers useful for the diagnosis of thrombosis? Semin Thromb Hemost 2008; 34(1):33–8.

Pallant J. SPSS Survival Manual - A Step by Step Guide to Data Analysis Using SPSS for Windows. 3rd ed. New York: McGraw-Hill; 2007.

Sharma P, Saxena R. Limited Utility of a Rapid Quantitative Enzyme-Linked Fluorescent Assay for the D-Dimer in the Diagnosis of Overt DIC. Clin Appl Thromb Hemost 2010; 16: 609-13.

Kaushansky K, Lichtman M. William’s Haematology. 8th ed. New York: McGraw-Hill; 2010.

Hoelzer D, Gökbuget N. Acute Lymphocytic Leukemia in Adults. In: Hoffman R. Haematology, Basic Principles and Practice. 5th ed. Netherlands: Elsevier; 2011.

Favaloro E. Laboratory Testing in DIC. Semin Thromb Hemost 2010; 36:458–68.

Published
2018-09-27
How to Cite
Akram, R., & Hassan, K. (2018). The frequency of disseminated intravascular coagulopathy in newly diagnosed adult patients with haematological malignancies attending Nanakaly Hospital in Erbil. Zanco Journal of Medical Sciences (Zanco J Med Sci), 18(2), 718 - 725. https://doi.org/10.15218/zjms.2014.0023
Section
Original Articles