Evaluation Of Soluble Fibrin Monomer Complex and D Dimer as Early Markers of Hypercoagulability in Patients with Acute Myeloid Leukemia

Abstract

Background: Hypercoagulability is a prominent feature in acute myeloid leukemia (AML), yet the underlying biomarkers and their relationship to disease burden remain incompletely characterized. D-dimer and soluble fibrin monomer complex (SFMC) are proposed as candidates for early detection of coagulopathy, but their distinct biological roles and clinical utilities require clarification.

Objective: This study aims to evaluate and compare plasma levels of D-dimer and SFMC in newly diagnosed AML patients versus healthy controls, and to investigate their correlations with disease parameters.

Methods: A cross-sectional analysis measured plasma D-dimer and SFMC in AML patients and controls. Correlations with leukocyte count, blast percentage, and platelet count were assessed. Receiver Operating Characteristic (ROC) curves evaluated diagnostic performance. Subtype-specific analyses, especially for M3, explored biomarker variability.

Results: AML patients had significantly higher D-dimer (median 1.2 μg/mL) and SFMC (median 7.3 μg/mL) than controls. D-dimer correlated with leukocyte count (ρ=0.39) and blast percentage (ρ=0.49); SFMC showed weak, non-significant correlations. ROC analysis revealed superior diagnostic performance for D-dimer (AUC=0.96) over SFMC (AUC=0.81). SFMC elevations were greatest in M3; neither marker correlated with platelet count.

Conclusion: Both biomarkers are elevated at AML diagnosis, with D-dimer reflecting overall fibrinolytic activity and SFMC identifying high-risk subgroups. Combined assessment could improve early risk stratification and guide prophylaxis; larger longitudinal studies should define cut-offs and validate prognostic value.