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Thromb Haemost 2000; 83(06): 906-908
DOI: 10.1055/s-0037-1613942
Commentary
Schattauer GmbH

Elastase Mediated Fibrinolysis in Acute Promyelocytic Leukemia

Erik-Jan D. Oudijk
1   From the Department of Haematology, University Medical Centre, Utrecht, the Netherlands
,
H. Karel Nieuwenhuis
1   From the Department of Haematology, University Medical Centre, Utrecht, the Netherlands
2   The Institute of Biomembranes, Utrecht University, the Netherlands
,
Rogier Bos
3   TNO-Prevention and Health, Leiden, The Netherlands
,
Rob Fijnheer
1   From the Department of Haematology, University Medical Centre, Utrecht, the Netherlands
› Author Affiliations
Further Information

Publication History

Received 05 November 1999

Accepted after revision 14 February 2000

Publication Date:
14 December 2017 (online)

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Summary

The bleeding syndrome of acute promyelocytic leukemia (APL) is complex and consists of disseminated intravascular coagulation (DIC) and hyperfibrinolysis. Elastase, derived from malignant promyelocytes, is believed to mediate the fibrinogeno- and fibrinolysis by aspecific proteolysis. In this study we measured the role of elastase in fifteen patients with APL by using an assay for elastase degraded fibrin(ogen) and the results were compared with those obtained in patients with sepsis induced DIC.

High levels of elastase were observed in sepsis and APL. The levels of fibrinogen and fibrin degradation products were significantly higher in APL patients compared to patients with sepsis induced DIC. Nevertheless, the level of elastase degraded fibrin(ogen) was higher in the sepsis group (635.3 ng/ml, compared to 144.3 ng/ml in APL; p <0.0001). So, the enormous increase in fibrin and fibrinogen degradation products in APL cannot be explained by elastase activity. This study suggests a minor role for elastase mediated proteolysis in the hemorrhagic diathesis in APL patients.

Key words

Acute promyelocytic leukemia - fibrinolysis - coagulation - sepsis - elastase
 

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