1984
DOI: 10.1002/ajh.2830160111
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A heparin‐like anticoagulant in an 8‐month‐old boy with acute monoblastic leukemia

Abstract: An 8-month-old male with acute monoblastic leukemia died during induction chemotherapy of severe bleeding refractory to repeated infusions of platelets and clotting factors. A heparin effect was suggested by prothrombin time (PT) of 26 seconds, partial thromboplastin time (PTT) of 94 seconds, thrombin time 240 seconds, and reptilase time 18.4 seconds, with a fibrinogen of 88 mg/dl. Both plasma mixed with the patient's urine and the patient's plasma had their thrombin times corrected toward normal by both PF4 a… Show more

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Cited by 33 publications
(17 citation statements)
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“…Coagulation studies have shown that the circulating heparan sulfate had anti-thrombin III cofactor activity that could be neutralized by platelet factor 4 or protamine [67]. Interestingly, a similar finding has been reported in an infant with acute monoblastic leukemia [68]. Although the specific cellular source of this anticoagulant molecule has not been clearly established, several possibilities should be considered: (1) the neoplastic cells may produce and release this molecule in large quantities; (2) the circulating proteoglycan may derive from the endothelial cells damaged by the chemotherapy, and (3) the circulating proteoglycan produced by the tumor cells may induce an immunological response toward endothelial cells or platelets.…”
Section: Heparan Sulfate and Transformationsupporting
confidence: 61%
“…Coagulation studies have shown that the circulating heparan sulfate had anti-thrombin III cofactor activity that could be neutralized by platelet factor 4 or protamine [67]. Interestingly, a similar finding has been reported in an infant with acute monoblastic leukemia [68]. Although the specific cellular source of this anticoagulant molecule has not been clearly established, several possibilities should be considered: (1) the neoplastic cells may produce and release this molecule in large quantities; (2) the circulating proteoglycan may derive from the endothelial cells damaged by the chemotherapy, and (3) the circulating proteoglycan produced by the tumor cells may induce an immunological response toward endothelial cells or platelets.…”
Section: Heparan Sulfate and Transformationsupporting
confidence: 61%
“…In rare pathological conditions, heparan sulfate and heparin-like molecules have been described as responsible for bleeding disorders [6,24,25]. However, the presence of 'real' heparin in plasma of healthy subjects is still a matter of discussion [11,22].…”
Section: Discussionmentioning
confidence: 99%
“…These heparin-like anticoagulants have been associated with hematological malignancies, mainly with multiple myeloma or plasma cell leukemia [1][2][3][4][5][6], and other neoplastic processes [7][8][9]. Other cases were observed in infected cirrhotic and noncirrhotic patients [10].…”
Section: Introductionmentioning
confidence: 99%