What is the role of coagulation studies and chemistry profiles in the workup of acute lymphoblastic leukemia (ALL)?

Updated: Oct 26, 2020
  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

On coagulation studies, a prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT), decreased fibrinogen levels, and the presence of fibrin split products may suggest concomitant disseminated intravascular coagulation (DIC).

A review of the peripheral blood smear confirms the findings of the CBC count. Circulating blasts are usually seen. Schistocytes are sometimes seen if DIC is present.

A chemistry profile is recommended. Most patients with ALL have an elevated lactate dehydrogenase level (LDH), and they frequently have an elevated uric acid level. In addition, liver function tests and blood urea nitrogen (BUN)/creatinine determinations are necessary before the initiation of therapy.


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