Asparaginase decreases clotting factors in vitro: a possible pitfall?
L-Asparaginase treatment of leukemia patients causes hemostatic problems. To investigate whether L-asparaginase influences coagulation studies, 63 blood samples of 21 healthy male donors were incubated with L-asparaginase for 30 min at room temperature. After treatment with 100 IU/ml L-asparaginase plasma fibrinogen (P = 0.002), plasma antithrombin (P = 0.0002), plasma protein C (P = 0.0004), and plasma plasminogen (P = 0.0039) were decreased compared with controls. In contrast, a significant increase in plasma von Willebrand factor antigen (P = 0.08) and plasma thromboglobulin (P = 0.005) was observed. The decrease in plasma anti-thrombin (P = 0.001), plasma protein C (P = 0.0003), and plasma plasminogen (P = 0.0043) was also measurable after 0.05 IU/ml asparaginase treatment. The incubation with L-asparaginase was similar to the normal time from blood sampling to testing and hence the results suggest that L-asparaginase may directly attack proteins of the coagulation system during the interval between sampling and assay.
Nowak-Göttl
U
U
Department of Pediatric Hematology and Oncology, University Children's Hospital, Münster, Germany.
Boos
J
J
Wolff
J E
JE
Lill
H
H
Veltmann
H
H
Werber
G
G
Ahlke
E
E
Jürgens
H
H
D000328:Adult; D000990:Antithrombin III / Q000378:metabolism; D001215:Asparaginase / Q000378:metabolism*; D001779:Blood Coagulation Factors / Q000378:metabolism*; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D011486:Protein C / Q000378:metabolism; D017293:Protein S / Q000378:metabolism; D013997:Time Factors; D014841:von Willebrand Factor / Q000378:metabolism
D001779:Blood Coagulation Factors; D011486:Protein C; D017293:Protein S; D014841:von Willebrand Factor; D000990:Antithrombin III; D005340:Fibrinogen; D001215:Asparaginase