Summary
In this study, we used plasma factor V activity and parameters of the thrombin generation test to discuss their diagnostic and prognostic value for disseminated intravascular coagulation (DIC) in patients with hematological malignancies. A total of 164 patients who were diagnosed with hematological malignancies in the Department of Hematology, Union Hospital, between Apr. 2014 and Dec. 2014 were enrolled in this study. There were 131 patients in the study group and 33 patients in the control group in terms of the laboratory results for DIC. The patients in the study group were divided into a DIC subgroup (n=59) and a non-DIC subgroup (n=72) based on the International Society of Thrombosis and Hemostasis (ISTH) Integral System, and they were divided into four subgroups [score ≤3 (n=35), score=4 (n=37), score=5 (n=47), and score ≥6 (n=12)] according to ISTH scores. Using 28-day mortality as the endpoint, the patients in the study group were divided into a survival subgroup (n=111) and a non-survival subgroup (n=20). The results showed that the plasma factor V activity was significantly weaker, and lag time and time to peak were significantly shorter in the study group than in the control group (P<0.01). The factor V activity, peak and endogenous thrombin potential (ETP) were significantly decreased in the DIC subgroup as compared with those in the non-DIC subgroup (P<0.01). Among factor V activity, lag time, peak, ETP, and ttPeak, only the factor V activity was significantly decreased in the non-survival subgroup compared with the survival subgroup (P<0.01). With the increase in ISTH score, the ETP and peak decreased gradually. The binary logistic regression analysis revealed that PLT, D-dimer, factor V activity and ETP had linear relationship with DIC diagnosed by ISTH Integral System. Using DIC diagnosed by ISTH Integral System as the endpoint, the area under curve (AUC) of factor V activity was found to be similar to that of blood platelet count (PLT) and prothrombin time (PT). In conclusion, factor V activity, ETP and peak had diagnostic value for DIC in patients with hematological malignancies, and only factor V activity had limited prognostic value.
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Levi M, van der Poll T. Disseminated intravascular coagulation: a review for the internist. Intern Emerg Med, 2013, 8(1):23–32
Hu Y. An interpretation of the Chinese experts’ consensus on the diagnosis and treatment of disseminated intravascular coagulation (2012 edition). J Clin Hematol (Chinese), 2013, 26(3):149–150
Singh RK, Baronia AK, Sahoo JN, et al. Prospective comparison of new Japanese Association for Acute Medicine (JAAM) DIC and International Society of Thrombosis and Hemostasis (ISTH) DIC score in critically ill septic patients. Thromb Res, 2012, 129(4):e119–e125
Taylor FB Jr, Toh CH, Hoots WK, et al. Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. Thromb Haemost, 2001, 86(5):1327–1330
Kobayashi N, Maekawa T, Takada M, et al. Criteria for diagnosis of DIC based on the analysis of clinical and laboratory findings in 345 DIC patients collected by the Research Committee on DIC in Japan. Bibl Haematol, 1983, (49):265–275
Gando S, Iba T, Eguchi Y, et al. A multicenter, prospective validation of disseminated intravascular coagulation diagnostic criteria for critically ill patients: comparing current criteria. Crit Care Med, 2006, 34(3):625–631
Bakhtiari K, Meijers JC, de Jonge E, et al. Prospective validation of the International Society of Thrombosis and Haemostasis scoring system for disseminated intravascular coagulation. Crit Care Med, 2004, 32(12):2416–2421
Gando S, Saitoh D, Ogura H, et al. A multicenter, prospective validation study of the Japanese Association for Acute Medicine disseminated intravascular coagulation scoring system in patients with severe sepsis. Crit Care, 2013, 17(3):R111
Takemitsu T, Wada H, Hatada T, et al. Prospective evaluation of three different diagnostic criteria for disseminated intravascular coagulation. Thromb Haemost, 2011, 105(1):40–44
Solano C, Lamuño M, Vargas A, et al. Comparison of the 1999 Sapporo and 2006 revised criteria for the classification of the antiphospholipid syndrome. Clin Exp Rheumatol, 2009, 27(6):914–919
Wada H, Wakita Y, Nakase T, et al. Outcome of disseminated intravascular coagulation in relation to the score when treatment was begun. Mie DIC Study Group. Thromb Haemost, 1995, 74(3):848–852
Liu W, Chai JK. Research Progresses in Disseminated Intravascular Coagulation. Chin J Injury Repair and Wound Healing (Electronic Edition), 2011, 6(3):447–453
Izumi S, Langley PG, Wendon J, et al. Coagulation factor V levels as a prognostic indicator in fulminant hepatic failure. Hepatology, 1996, 23(6):1507–1511
Seo JW, Kim HK, Kim JE, et al. Prognostic values of the factor Xa-activated clotting time and endogenous thrombin potential in patients suspected of having disseminated intravascular coagulation. Thromb Res, 2009, 123(4):565–572
Acknowledgments
We thank all the members of the Institute of Hematology in Union Hospital, Wuhan, for their active participation in discussing test procedures, and we give special thanks to Yan YANG for sample collection and technological help.
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Kou, Hm., Zhang, Xp., Wang, Mz. et al. Diagnostic and Prognostic Value of Plasma Factor V Activity and Parameters in Thrombin Generation for Disseminated Intravascular Coagulation in Patients with Hematological Malignancies. CURR MED SCI 39, 546–550 (2019). https://doi.org/10.1007/s11596-019-2072-9
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DOI: https://doi.org/10.1007/s11596-019-2072-9