Changes in plasma levels of protease and fibrinolytic inhibitors induced by treatment in acute myeloid leukemia

Thromb Haemost. 1984 Aug 31;52(1):81-4.


We have studied the main protease inhibitors of leukocytes, alpha-1-protease (alpha 1-PI), alpha-1-antichymotrypsin (alpha 1-Achy) and alpha-2-macroglobulin (alpha 2-M), as well as different parameters of coagulation and fibrinolysis in 21 cases of acute nonlymphoblastic leukemia (ANLL) before, during and after therapy. Nine of the patients presented signs of DIC, 8 of whom belonged to subtype M3 and to subtype 1 M1. The initial alpha 1-PI and alpha 1-Achy levels, which were elevated, increased during the treatment period. There was no significant difference between patients with and without DIC. However, those leukemic patients with DIC showed a significant decrease in plasminogen (p less than 0.005) and fast antiplasmin (p less than 0.01) only during the treatment compared with DIC free patients. All DIC cases demonstrated circulating plasmin-antiplasmin complex (P-AP) both before and during treatment. Independent of a possible proteolytic action of leukocyte enzymes on clotting factors in the clinical course of ANLL (mainly M3 subtype), our results suggest an activation of plasmin-mediated fibrinolysis related to the activation of plasminogen by leukocytes, reactive DIC or both.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antifibrinolytic Agents / blood*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Child
  • Disseminated Intravascular Coagulation / blood
  • Disseminated Intravascular Coagulation / complications
  • Female
  • Fibrinolysin / metabolism
  • Humans
  • Leukemia, Myeloid, Acute / blood*
  • Leukemia, Myeloid, Acute / complications
  • Leukemia, Myeloid, Acute / drug therapy
  • Male
  • Middle Aged
  • Protease Inhibitors / blood*
  • alpha-2-Antiplasmin / metabolism


  • Antifibrinolytic Agents
  • Protease Inhibitors
  • alpha-2-Antiplasmin
  • Fibrinolysin