PMID: 8599991Jan 1, 1996Paper

Inhibition of hypercoagulation by antithrombin substitution in E. coli L-asparaginase-treated children

European Journal of Haematology
U Nowak-GöttlH Jürgens

Abstract

Acquired deficiency of antithrombin (AT), which in some patients could lead to thrombosis, has been a serious side effect of protocols which incorporate E. coli L-asparaginase (ASP) for the treatment of acute lymphoblastic leukaemia (ALL). In a longitudinal, prospective, non-randomized study children with ALL (n=27) were treated according to the protocol ALL-BFM-90. During the induction phase using prednisone, vincristine, daunorubicin and ASP, AT substitution was performed in 15/27 patients, when their plasma concentration decreased below 60% of normal with a concomitant increase of D-dimer formation. After the administration of the AT concentrate the patients, plasma concentration of AT increased and remained elevated after 18, 48, and 72 h. In addition, the plasma concentration of enhanced thrombin generation, D-dimer formation and plasminogen activator inhibitor 1 decreased towards normal levels. Although the observed laboratory findings may serve as evidence for a possible clinical benefit of AT substitution during ASP treatment, further randomized studies are requested to evaluate whether the use of prophylactic AT administration could reduce the incidence of thromboembolic events in childhood acute leukaemia.

References

Apr 1, 1975·Thrombosis Research·O R OdegardU Abildgaard
Feb 1, 1994·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·M G MazzucconiF Mandelli
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Citations

Jul 4, 2012·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Meryem AlbayrakUlker Koçak
Oct 24, 2014·Thrombosis and Haemostasis·V De StefanoE Rossi
Feb 22, 2017·Frontiers in Pediatrics·Richard H Ko, Courtney D Thornburg
Feb 1, 2018·British Journal of Haematology·Keith R SibsonUNKNOWN British Society for Haematology
Feb 16, 2006·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Inge M AppelRob Pieters
Sep 24, 2013·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Susanna RantaAnne M-T Mäkipernaa
Jul 5, 2007·British Journal of Haematology·Jeanette H Payne, Ajay J Vora
Aug 15, 2015·Future Oncology·Gaurav Goyal, Vijaya Raj Bhatt
Jan 25, 2003·British Journal of Haematology·Nethnapha ParedesAnthony K C Chan

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