Correction of hemostatic imbalances induced by L-asparaginase therapy in children with acute lymphoblastic leukemia.
Thirteen children with ALL and L-asp-induced alterations of the coagulation system were treated with fresh-frozen plasma and antithrombin III (AT III) concentrate. Fresh-frozen plasma was given three times daily to maintain fibrinogen levels greater than 100 mg/dl. AT III concentrate was administered in a continuous infusion over 24 h as long as replacement with fresh-frozen plasma was given. When fibrinogen was greater than 100 mg/dl and AT III less than 80% of normal, only AT III concentrate was administered in a continuous infusion. In all patients treated with the replacement regimen described, fibrinogen levels were maintained greater than 100 mg/dl and AT III levels greater than 80%. No bleeding or thrombosis and no signs of disseminated intravascular coagulation were observed. Our study shows that correction of the alterations of the coagulation system induced by asparaginase can be achieved with a replacement regimen substituting both procoagulant material and the most important inhibitor of the coagulation system.
Zaunschirm
A
A
Department of Pediatrics, University of Graz, Austria.
Muntean
W
W
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000990:Antithrombin III / Q000032:analysis; D001215:Asparaginase / Q000009:adverse effects* / Q000627:therapeutic use; D001778:Blood Coagulation Disorders / Q000139:chemically induced*; D001780:Blood Coagulation Tests; D002648:Child; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D012074:Remission Induction
D000990:Antithrombin III; D005340:Fibrinogen; D001215:Asparaginase