1. An antithrombin replacement strategy during asparaginase therapy for acute lymphoblastic leukemia is associated with a reduction in thrombotic events.
- Author
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Farrell, Katrina, Fyfe, Andrew, Allan, Jonathan, Tait, R. Campbell, and Leach, Mike
- Subjects
LYMPHOBLASTIC leukemia treatment ,CANCER treatment complications ,THROMBOSIS risk factors ,ASPARAGINASE ,ANTITHROMBINS ,THERAPEUTICS - Abstract
Thrombosis is a well-recognized complication of asparaginase therapy for acute lymphoblastic leukemia (ALL), associated with the depletion of antithrombin (AT). Following a high incidence of thrombotic episodes during induction therapy for ALL in our tertiary referral center, we prospectively instituted a protocol of AT replacement. Forty-five consecutive adolescents and adults with ALL treated with asparaginase-containing phase I induction protocols were included in this observational study. Fifteen received standard therapy with no replacement; the subsequent 30 were managed with the protocol described. One or more low AT levels (<70 iu/dl) were recorded in 76% of patients in the cohort managed using the protocol, resulting them in receiving an AT replacement. There was a significant reduction in the incidence of thrombosis with this strategy (0/30 vs. 5/15,p < 0.001). We suggest that such a strategy should be studied in a prospective randomized sub-study within the context of a national ALL trial. [ABSTRACT FROM PUBLISHER]
- Published
- 2016
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