Thrombosis in children receiving L-asparaginase. Determining patients at risk.
OBJECTIVE
A prospective study of coagulation in 15 children who received L-asparaginase, vincristine, or prednisone plus or minus an anthracycline as part of a treatment program for leukemia or leukemia-lymphoma syndrome was conducted.


METHODS
One patient developed a central nervous system thrombosis.


RESULTS
The inhibitors of coagulation, including antithrombin-III, protein C, protein S, and plasminogen, were decreased in many individuals, but were not significantly different in the patient who had experienced the thrombotic event. Platelet aggregations to low molar ADP were performed in four patients, and in three patients showed a hyperaggregable pattern.


CONCLUSIONS
The patient with thrombosis developed a transient acquired type II pattern on multimeric analysis of the von Willebrand factor, which was not seen in the other individuals studied.
Shapiro
A D
AD
Division of Pediatric Hematology-Oncology, James Whitcomb Riley Hospital for Children, Indianapolis, Indiana 46202-5225.
Clarke
S L
SL
Christian
J M
JM
Odom
L F
LF
Hathaway
W E
WE
D000293:Adolescent; D001215:Asparaginase / Q000009:adverse effects*; D001779:Blood Coagulation Factors / Q000032:analysis; D001780:Blood Coagulation Tests; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010974:Platelet Aggregation; D010976:Platelet Count; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000188:drug therapy*; D011446:Prospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000139:chemically induced* / Q000453:epidemiology*; D014841:von Willebrand Factor / Q000032:analysis
D001779:Blood Coagulation Factors; D014841:von Willebrand Factor; D001215:Asparaginase