Clotting abnormalities in children during maintenance chemotherapy for acute lymphoblastic leukemia.
BACKGROUND
Many of the drugs used in the treatment of acute lymphoblastic leukemia in children may induce modifications in different organs and functions. Following the observation of a recurrent, mild delay in the prothrombin time in ALL children during maintenance chemotherapy, we explored the main parameters of the clotting function.


METHODS
17 children with acute lymphoblastic leukemia were studied during maintenance chemotherapy for clotting function screening evaluation; 15 healthy children, matched for age and sex, were used as controls.


RESULTS
A uniform pattern of slight prolongation of the prothrombin time with significantly reduced levels of factors VII, IX, and a trend toward reduced activity of factor X was observed in the absence of any demonstrable anticoagulant factor.


CONCLUSIONS
Antileukemic maintenance chemotherapy is associated with a subclinical modification of the clotting parameters that is not responsible for hemorrhagic diathesis. Long-term administration of anti-metabolites (6-mercaptopurine and methotrexate) could be responsible for this reversible impairment.
Aricò
M
M
Dipartimento di Pediatria, Università di Pavia, IRCCS Policlinico San Matteo, Italy.
Gamba
G
G
Raiteri
E
E
Montani
N
N
De Amici
M
M
Burgio
G R
GR
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001778:Blood Coagulation Disorders / Q000139:chemically induced*; D001779:Blood Coagulation Factors / Q000032:analysis; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000188:drug therapy*; D011241:Prednisone / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage
D001779:Blood Coagulation Factors; D014750:Vincristine; D015122:Mercaptopurine; D011241:Prednisone; D008727:Methotrexate