Exploring the Role and Changes of a Disintegrin and Metalloproteinase with a Thrombospondin Type 1 Motif, Member 13 and Von Willebrand Factor Ag in Patients with Acute Myelogenous Leukemia.

BACKGROUND

Acute myeloid leukemia (AML) is a hematologic malignancy associated with significant coagulation abnormalities and endothelial dysfunction. Von Willebrand factor (VWF) and its regulatory protease, a disintegrin and metalloproteinase with thrombospondin type 1 motif member 13 (ADAMTS13), play essential roles in maintaining vascular homeostasis. Disruption of this balance may contribute to thrombotic complications in AML.

METHODS

This case-control study included 40 newly diagnosed, untreated AML patients and 40 age- and sex-matched healthy controls recruited from Al-Azhar University Hospitals, Cairo, Egypt. Plasma VWF antigen levels and ADAMTS13 activity were measured using enzyme-linked immunosorbent assay (ELISA). Statistical comparisons between groups were performed using appropriate parametric tests, and correlation analysis was conducted to assess the association between both biomarkers.

RESULTS

AML patients showed significantly higher plasma VWF antigen levels compared with controls (274.44 ± 139.72% vs. 111.40 ± 31.77%, P < 0.001). In contrast, ADAMTS13 activity was significantly lower in AML patients than in controls (46.70 ± 29.37% vs. 99.01 ± 27.09%, P < 0.001). An inverse correlation was observed between VWF antigen and ADAMTS13 activity (r = -0.28), although this did not reach statistical significance (P = 0.08).

CONCLUSIONS

Newly diagnosed AML patients demonstrate significant imbalance in the VWF-ADAMTS13 axis, characterized by elevated VWF levels and reduced ADAMTS13 activity. These findings support the presence of early endothelial dysfunction and hemostatic disturbance prior to treatment initiation. Further large-scale prospective studies are needed to determine the prognostic and clinical significance of these biomarkers.