title: Supranormal antithrombin III levels induced by concentrate administration are ineffective in quenching thrombin generation in acute promyelocytic leukemia.
abstract: Coagulation abnormalities occurring in patients with acute promyelocytic leukemia (APL) are partially corrected by heparin administration. This study was undertaken to verify if "supra-normal" levels of antithrombin III (AT-III) are similarly able to quench intravascular thrombin generation triggered by APL cells. Eight patients with APL were randomly assigned to receive either 50 U/kg (Group A) or 100 U/kg (Group B) of an AT-III concentrate, starting on the first day of chemotherapy and continuing for 7 days thereafter. Fibrinopeptide A (FPA), prothrombin fragment F1+2 and thrombin-AT III complexes, measured before and 15 minutes after each AT-III infusion, decreased significantly after each infusion, but the effect was minimal and short-lived, despite the achievement of post-infusion levels of AT-III activity well above 150% (Group A) or 200% (Group B). Small amounts of heparin were consistently detected in AT-III concentrates and post-infusion plasma samples. The short-lived quenching of thrombin generation after AT-III concentrate could be partially explained by the infusion of heparin, rather than by supranormal AT-III levels.
authors: Department of Hematology, San Bortolo Hospital, Vicenza, Italy.
authors: F
authors: F
authors: Rodeghiero
authors: G
authors: G
authors: Castaman
authors: L
authors: L
authors: Gugliotta
authors: M
authors: M
authors: Mattioli Belmonte
authors: A
authors: A
authors: Falanga
authors: B
authors: B
authors: Bottasso
authors: T
authors: T
authors: Barbui
authors: P M
authors: PM
authors: Mannucci
mesh_terms: D000328:Adult; D000368:Aged; D000990:Antithrombin III / Q000008:administration & dosage* / Q000378:metabolism; D001777:Blood Coagulation / Q000187:drug effects; D001803:Blood Transfusion; D005260:Female; D005344:Fibrinopeptide A / Q000378:metabolism; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D015473:Leukemia, Promyelocytic, Acute / Q000097:blood / Q000188:drug therapy* / Q000628:therapy; D008875:Middle Aged; D010446:Peptide Fragments / Q000378:metabolism; D010447:Peptide Hydrolases / Q000378:metabolism; D017713:Platelet Transfusion; D011516:Prothrombin / Q000378:metabolism; D013917:Thrombin / Q000378:metabolism*
chemical_list: D010446:Peptide Fragments; C046193:antithrombin III-protease complex; C045879:prothrombin fragment 1.2; D005344:Fibrinopeptide A; D000990:Antithrombin III; D011516:Prothrombin; D006493:Heparin; D010447:Peptide Hydrolases; D013917:Thrombin