ISSN 2997-1036
International Journal of Hematology | Vol. 6, No. 6, June 2015 | pp. 41–48
DOI: 10.46882/2015/IJH/000066
Original Article
Title: Evaluation of baseline plasma fibrinogen levels as a prognostic indicator in acute myeloid leukemia patients
Names of Authors: E. F. Chinedu¹, G. H. Haruna², I. J. Balogun³
Authors’ Affiliations: ¹Department of Haematology, University of Nigeria Teaching Hospital, Enugu, Nigeria; ²Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Nigeria; ³Department of Chemical Pathology, University of Ilorin, Ilorin, Nigeria
Abstract: Coagulation abnormalities frequently complicate the clinical course of acute myeloid leukemia, yet the prognostic value of baseline fibrinogen remains under-studied. This prospective study evaluated plasma fibrinogen levels in 55 newly diagnosed adult patients with acute myeloid leukemia (excluding acute promyelocytic leukemia) to assess its correlation with induction remission success and 1-year survival outcomes. Fibrinogen was quantified using the Clauss clotting assay before starting standard cytarabine-daunorubicin chemotherapy. Hypofibrinogenemia (< 1.50 g/L) was detected in 14.5% of the patients, while hyperfibrinogenemia (> 4.50 g/L) was present in 21.8%. Multivariate analysis identified baseline hypofibrinogenemia as an independent predictor of early hemorrhagic mortality during induction therapy (odds ratio = 4.12, P < 0.01). Conversely, hyperfibrinogenemia correlated with high white blood cell counts and increased risk of tumor lysis syndrome. Patients with normal baseline fibrinogen levels (1.50 to 4.50 g/L) demonstrated significantly higher 1-year overall survival compared to abnormal cohorts (P < 0.05). Pre-treatment fibrinogen screening provides valuable prognostic utility, helping identify patients at high risk for fatal bleeding or hyperinflammatory reactions during induction regimens.
Keywords: Acute myeloid leukemia, fibrinogen, hypofibrinogenemia, early mortality, prognosis
Manuscript Timeline: Received: March 14, 2015; Revised: April 25, 2015; Accepted: May 12, 2015; Published: June 19, 2015