title: Thrombotic complications during induction chemotherapy of acute childhood lymphoblastic leukemia.
abstract: The incidence of thrombosis during induction chemotherapy of acute childhood lymphoblastic leukemia (ALL) patients was 6 found to be in 105 (5.7%). There were 4 cerebral infarctions, 1 superior vena cava (SVC) obstruction and 1 deep vein thrombosis. Among these, 2 of them died. A prospective study was further conducted of the change in coagulation and anticoagulation factors during 6 weeks of induction chemotherapy. It was found that the activated partial thromboplastin time (aPTT) was within normal range in all cases throughout 6 weeks, while prothrombin time (PT) and thrombin time (TT) were slightly prolonged, especially during the first 3 weeks of this phase. The natural anticoagulant panels which included protein C (PC), protein S (PS) and antithrombin III (AT III) and also fibrinogen level, were lower during the first 3 weeks and reached its nadir during the second and third week. The lower level of natural anticoagulants might be an important predisposing factor for the occurrence of thrombosis in these patients.
authors.affiliation: Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Suthida
authors.initials: S
authors.lastname: Kankirawatana
authors.forename: Gavivann
authors.initials: G
authors.lastname: Veerakul
authors.forename: Kleebsabai
authors.initials: K
authors.lastname: Sanpakit
authors.forename: Voravarn S
authors.initials: VS
authors.lastname: Tanphaichitr
authors.forename: Patraporn
authors.initials: P
authors.lastname: Akkabutr
authors.forename: Lerlugsn
authors.initials: L
authors.lastname: Suwantol
authors.forename: Chularatana
authors.initials: C
authors.lastname: Mahasandana
mesh_terms: D017677:Age Distribution; D000925:Anticoagulants / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D001778:Blood Coagulation Disorders / Q000503:physiopathology; D001780:Blood Coagulation Tests; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis / Q000188:drug therapy*; D012074:Remission Induction; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D013785:Thailand / Q000453:epidemiology; D013927:Thrombosis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology*
chemical_list: D000925:Anticoagulants