Isolated Factor V and X deficiencies were associated with acute leukemia in 2 patients. Both patients manifested a hemorrhagic diathesis. In the patient with Factor V deficiency, the level of Factor V was related to the activity of his leukemia. The mechanism of these deficiencies is unclear, but therapy should be directed to correcting the hemostatic mechanism until a hematologic remission can be attained.
HEMORRHAGIC DIATHESIS, RELATED TO
A thrombocytopenia, is common in acute leukemia. Bleeding due to coagulation factor deficiencies in leukemia is comparatively rare. Exceptions are associated with acute promyelocytic leukemia,59 27 liver disease from drug toxicity, or leukemic infiltration,e and sepsis.4 Hypofibrinogenemia has been reported in various types of leukemia.12 I n leukemia acquired coagulation factor deficiencies involving one factor are uncommon, and when present have not been correlated with a hemorrhagic diathesis.17 Two patients with acute leukemia, one lymphoblastic and one myeloblastic, had unique coagulation abnormalities consisting of an acquired coagulation factor defect involving Factor X in one patient and Factor V in the other.
Methods
Blood for all tests was collected through 19-gauge needles into plastic syringes. T h e blood was transferred to plastic tubes containing one part 40% sodium citrate to 100 parts blood or 20% potassium oxalate to 50 parts blood. T h e plasma was separated and frozen at -3OC and assayed within 24 hours or kept at 4C and assayed immediately. Blood clotted in the presence of epsilon aminocap roic acid (final concentration 0 . 2 M ) was allowed to stand for 4 hours at 37C, and the