High syndecan-1 levels in acute myeloid leukemia are associated with bleeding, thrombocytopathy, endothelial cell damage, and leukocytosis

The risk of hemorrhage is influenced by multiple factors in acute myeloid leukemia (AML). We investigated whether hemorrhage in AML patients was associated with endothelial perturbation, potentially caused by thrombocytopenia, platelet dysfunction and leukocytosis. Biomarkers of endothelial perturbation, coagulation and platelet activation were analyzed in 49 AML patients, along with previously collected data on bleeding status and platelet activation markers. High levels of syndecan-1, a marker of endothelial glycocalyx degradation, were associated with bleeding, impaired platelet function, higher age, endothelial cell activation and damage, and leukocytosis. We suggest that platelet dysfunction and leukocytosis in AML causes endothelial perturbation.