Hemorrhagic syndrome in patients with acute myeloid leukemia and the effect of coagulation disorders on the course of the disease
Summary. Bleeding events are considered among the most common and dangerous complications in patients with newly diagnosed acute myeloid leukemia (AML) and severely impacts survival rates at the time of the diagnosis and in different periods of treatment. Bleeding in a patient with AML is usually associated with low platelet counts, coagulation disorders due to reduced platelet functions or abnormalities in the external or internal coagulation pathways. Prophylactic platelet transfusions considered as the main method of prevention of bleeding in patients with thrombocytopenia at different stages of diagnosis and treatment of AML. Von Willebrand factor is a large glycoprotein that circulates in plasma and is released from alpha granules of platelets and endothelial cells in response to various stimuli. It provides two main functions: it mediates the adhesion of platelets to the sites of vascular wall damage and also as it binds and stabilizes the procoagulant protein — coagulation factor VIII. A comprehensive analysis of the functional activity of vWF is defined for many lymphoproliferative and myeloproliferative diseases and is taken into account when prescribing treatment in these patients. Despite the available scales for assessing the risk of bleeding — IMPROVE, ATRIA, HAS-BLED, HEMORR2HAGES, etc., almost all of them are developed for elderly patients or those taking direct oral anticoagulants or warfarin. This paper presents a review of literature data on the frequency and main mechanisms of hemorrhagic syndrome in patients with AML, evaluation of the effectiveness of platelet transfusions in hematological patients according to the latest data and possible additional mechanisms of bleeding in patients with AML.
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