Hidemi Gonmori

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

From analysis of the clinical and laboratory findings in the DIC patients collected by JRDC, diagnostic criteria for the diagnosis of DIC are proposed. The characteristics of the criteria are as follows: (1) a scoring system is adopted; (2) as the tests for scoring, PT, plasma Fbg level, serum FDP level, and platelet count are used; (3) different scores are given according to the grade of change in the results of the tests; (4) bleeding and clinical signs indicating organ dysfunction due to DIC are included in the scoring system; and (5) recognition of the well-known etiological factors of DIC is also scored.

The Role of Tissue Thromboplastin in the Development of DIC Accompanying Neoplastic Diseases

Procoagulant activity of gastric cancer tissues and leukocytes obtained from various types of leukemia have been studied with special reference to TTP. The following results were obtained. Homogenates of APL leukocytes and gastric cancer tissues contained strong procoagulant activities, most of which have been identified as TTP since the activities were neutralized by a specific antibody against purified human placenta TTP, inactivated by the removal of phospholipid with heptane-butanol mixture, and inactivated by the addition of phospholipase C. The delipidated homogenates regained procoagulant activities by relipidation procedures. These results also confirmed that TTP from APL leukocytes and gastric cancer tissues have the same lipoprotein properties as those of TTP in normal tissues. Though slight proteolytic activity and fibrinolytic activity were demonstrated in the homogenate of gastric cancer tissues, it was noted that the TTP activity was different from these two activities by partial purification of TTP from gastric cancer tissues. The TTP activity of 9 homogenates of gastric cancer tissues was 301 +/- 289 (mean +/- SD) units per mg protein, being higher in homogenates of mucinous adenocarcinoma and signet-ring cell carcinoma than in those of tubular and poorly differentiated adenocarcinoma. The mean TTP activity of leukocyte homogenates from 14 patients with APL and one out of 4 patients with CML in blastic crisis was 81 +/- 76 units/10(7) cells. The TTP activity of the homogenates of leukocytes from 7 out of 18 patients with AML and another patient with CML in blastic crisis ranged from one to six units/10(7) cells with a mean of 3.3 +/- 1.2. The TTP activity of leukocyte homogenates from the other 11 cases of AML, two cases of CML in blastic crisis, 6 cases of CML, and one case each of ALL and CLL were less than one unit/10(7) cells. In leukemic patients, all cases with a value of more than 202 for the product of units of TTP activity per 10(7) cells and differential count (%) of leukemic cells in the bone marrow smear (MU value) were accompanied by DIC. The MU value of leukemic patients correlated well to the plasma fibrinogen and serum FDP levels. All patients with a MU value of more than 277 died of DIC when a sufficient amount of heparin was not administered. On the other hand, no DIC developed in any of the patients with a MU value of less than 90.(ABSTRACT TRUNCATED AT 400 WORDS)

Studies on tissue thromboplastin. IV Tissue thromboplastin of leukemic leukocytes from various types of acute non-lymphoid leukemic leukocyte.

In this paper, results obtained from the study on tissue factor in leukemic leukocytes are described. Leukemic leukocytes were obtained from 35 paitents with acute non-lymphoid leukemias (ANLL) (M1=7, M2=11, M3=3, M4=10, M5=2, M6=2 cases). The TP procoagulant activity (TPA) of the homogenized leukemic leukocytes was measured by Nemersons two-stage method and the amount of TP-apoprotein (TPR: Ag) was determined by RIA employing the sequential saturation technique of double antibody method which was previously reported.Mean value of TPA and TPR: Ag of M3 were 35.5±24.2U/ml and 156.7±47.3ng/ml, which were significantly higher than those of the other types of ANLL (1.5±1.4U/ml and 74.8±53.3ng/ml, respectively). Thus, the mean value of specific activity of TP (TPA/TPR: Ag) was higher in M3 (27.8±21.1U/mg) than those in the other types of ANLL (2.8±2.5U/mg). There was a significant relationship between log TPA and log TPR: Ag in these 35 patients.In conclusion, M3 leukocytes have higher TP specific activity than those of the other types of ANLL. Further studies are required to elucidate the nature of the difference in specific activity of leukocyte TP among various types of leukemia.