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2021, vol. 2, br. 2, str. 99-109
Diseminovana intravaskularna koagulopatija u akutnoj nepromijelocitnoj mijeloidnoj leukemiji - učestalost, kliničko-laboratorijske karakteristike i prognostički značaj
aUniverzitet u Beogradu, Medicinski fakultet
bUniverzitet u Beogradu, Medicinski fakultet + Klinički centar Srbije, Klinika za hematologiju, Beograd

e-adresamimamima.cvetkovic@gmail.com
Ključne reči: akutna mijeloidna leukemija; diseminovana intravaskularna koagulopatija; ishod; preživljavanje
Sažetak
Uvod: Diseminovana intravaskularna koagulopatija (DIK) je prisutna kod 90% bolesnika sa akutnom promijelocitnom leukemijom (APL). Učestalost DIK-a kod ostalih tipova akutnih mijeloidnih leukemija (ne-APL AML) je znatno manja (10-40%) i do sada ne postoje studije koje su ispitivale uticaj DIK-a na ranu smrt kod ovih bolesnika. Cilj: Cilj rada bio je da se izvrši analiza učestalosti diseminovane intravaskularne koagulopatije, njenih kliničko-laboratorijskih karakteristika, kao i uticaj na preživljavanje i ranu smrt bolesnika sa ne-APL AML-om. Materijal i metode: Retrospektivnom analizom je obuhvaćeno 176 bolesnika sa ne-APL AML-om, koji su dijagnostikovani i lečeni na Klinici za hematologiju Univerzitetskog Kliničkog centra Srbije (UKCS) u periodu od 2015. do 2020. godine. Dijagnoza DIK-a je postavljena na osnovu ISTH (engl. International Society on Thrombosis and Haemostasias) kriterijuma. Rezultati: Prosečna starost bolesnika iznosila je 53,8±14,5 godina, uz prevalenciju muškog pola (99/176; 56,2%). Manifestna diseminovana intravaskularna koagulopatija konstatovana je kod 74/176 bolesnika (42%), koji su značajno češće imali hemoragijski sindrom (p = 0,01). Faktori rizika za nastanak DIK-a bili su: starije životno doba (p < 0,01), prisustvo komorbiditeta (p = 0,01), leukocitoza (p < 0,001) i visoka koncentracija LDH (p < 0,001). FAB (engl. French, American and British) podtip neAPL AML-a, citogenetska grupa rizika i ekspresija CD56 (engl. cluster of differentiation) nisu uticali na nastanak DIK-a (p > 0,05). Nije utvrđena razlika u ranoj smrtnosti, ishodu i preživljavanju ne-APL AML bolesnika, sa i bez DIK-a (p > 0,05). Zaključak: Starije životno doba, prisustvo komorbiditeta, leukocitoza i visoke koncentracije LDH nose značajan rizik za razvoj DIK-a, kod bolesnika sa ne-APL AML-om. Prisustvo manifestne diseminovane intravaskularne koagulopatije ne utiče negativno na ranu smrtnost, ishod i preživljavanje bolesnika sa ne-APL AMLom, ukoliko se dijagnoza DIK-a postavi na vreme i preduzme neodložna, adekvatna i intenzivna primena suportivne terapije derivatima i komponentama krvi.
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O članku

jezik rada: srpski, engleski
vrsta rada: originalan članak
DOI: 10.5937/smclk2-32467
primljen: 25.06.2021.
revidiran: 25.06.2021.
prihvaćen: 25.06.2021.
objavljen onlajn: 25.06.2021.
objavljen u SCIndeksu: 14.07.2021.