Eduardo Rego, MD, PhD from University of São Paulo, Brazil discusses coagulopathy in acute myeloid leukemia (AML) at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark. There are several new features that are now known, such as the presence of microparticles derived from self-fragments of leukemia cells as well as healthy cells. These microparticles have a very high expression of tissue factor (TF). TF plays an important role in coagulation. Experimental studies on annexin II which is a surface receptor that binds to plasminogen and TPA, have shown a subsequent increases in plasmin generation. This knowledge has guided research in mice which has demonstrated that an increased concentration of homocysteine competes with TPA to inhibit annexin II, which can partially reverse fibrinolysis in APL.
The main challenges facing practitioners treating APL
