Inefficacy of fresh frozen plasma in the treatment of L-asparaginase-induced coagulation factor deficiencies during ALL induction therapy.
A prospective longitudinal study was conducted to determine whether single-donor fresh frozen plasma (FFP) substitution was able to influence L-asparaginase-associated hypoproteinemia. Within a 36-month period, 20 of 42 children with ALL received a total of 42 prophylactic FFP doses at a median of 10 (5-20) mliter/kg when fibrinogen levels decreased to < 60 mg/dL and thrombin time was lengthened. Laboratory monitoring before, during and after FFP substitution showed no short-term improvements and demonstrated only a minimal increase in fibrinogen and alpha 2-antiplasmin. Plasma levels of antithrombin and plasminogen remained unchanged. Furthermore, administration of FFP had no influence on thrombin generation, the plasmin/alpha 2-antiplasmin complex or enhanced D-dimer formation.
Nowak-Göttl
U
U
Center of Pediatric Hematology and Oncology, University Hospital Münster, Germany.
Rath
B
B
Binder
M
M
Hassel
J U
JU
Wolff
J
J
Husemann
S
S
Ritter
J
J
D000347:Afibrinogenemia / Q000139:chemically induced; D000933:Antifibrinolytic Agents; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000991:Antithrombins / Q000172:deficiency; D001215:Asparaginase / Q000008:administration & dosage / Q000009:adverse effects*; D001778:Blood Coagulation Disorders / Q000139:chemically induced* / Q000628:therapy*; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005341:Fibrinolysin / Q000032:analysis; D010949:Plasma; D010958:Plasminogen / Q000172:deficiency; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D011486:Protein C / Q000032:analysis; D013918:Thrombin Time; D017211:Treatment Failure; D000979:alpha-2-Antiplasmin / Q000032:analysis
D000933:Antifibrinolytic Agents; D000991:Antithrombins; D005338:Fibrin Fibrinogen Degradation Products; D011486:Protein C; D000979:alpha-2-Antiplasmin; C037742:plasmin-plasmin inhibitor complex; D010958:Plasminogen; D005341:Fibrinolysin; D001215:Asparaginase