Thrombotic events have been reported in acute lymphoblastic leukaemia patients, especially during or after L-asparaginase administration. A so-called L-asparaginase associated coagulopathy has been well recognized, being characterized by a hypercoagulable state (decrease of antithrombin III, plasminogen, protein C, protein S and increase of prothrombin fragment F1 + 2, thrombin-antithrombin complexes and fibrinopeptide A). The aim of this study was to determine whether the supplementation of antithrombin III (AT-III) concentrates could improve the L-asparaginase associated coagulopathy, thereby blocking the activation of the haemostatic system. In 25 adult patients with acute lymphoblastic leukaemia (M 19, F6, mean age 34 years) antithrombin III (AT-III) concentrates were administered at daily doses of 50 U/kg for 10 consecutive days from the beginning of L-asparaginase therapy (6,000 U/m2/day s.c. for 7 days), given according to the GIMEMA ALL 0288 trial. A marked increase of antithrombin III was recorded on days IV-VIII-XI (P < 0.001). No changes in protein C, protein S, plasminogen, alpha 2-antiplasmin, factor VII and platelet count were observed and there was no increase in markers of hypercoagulability. There was no evidence of disseminated intravascular coagulation. In conclusion, AT-III concentrate supplementation during L-asparaginase therapy, by the achievement of high levels of antithrombin III, is associated with a lack of activation of the haemostatic system and appears to overcome the complex coagulopathy associated with L-asparaginase.

ANTITHROMBIN III INFUSION SUPPRESSES THE HYPERCOAGULABLE STATE IN ADULT ACUTE LYMPHOBLASTIC LEUKAEMIA PATIENTS TREATED WITH A LOW-DOSE OF ESCHERICHIA COLI L-ASPARAGINASE. A GIMEMA STUDY / Mazzucconi, Maria Gabriella; Gugliotta, L; Leone, G; Dragoni, F; MATTIOLI BELMONTE, M; DE STEFANO, V; Chistolini, A; Tura, S; Mandelli, F.. - In: BLOOD COAGULATION & FIBRINOLYSIS. - ISSN 0957-5235. - 5:(1994), pp. 23-28. [10.1097/00001721-199402000-00004]

ANTITHROMBIN III INFUSION SUPPRESSES THE HYPERCOAGULABLE STATE IN ADULT ACUTE LYMPHOBLASTIC LEUKAEMIA PATIENTS TREATED WITH A LOW-DOSE OF ESCHERICHIA COLI L-ASPARAGINASE. A GIMEMA STUDY

MAZZUCCONI, Maria Gabriella;CHISTOLINI A;
1994

Abstract

Thrombotic events have been reported in acute lymphoblastic leukaemia patients, especially during or after L-asparaginase administration. A so-called L-asparaginase associated coagulopathy has been well recognized, being characterized by a hypercoagulable state (decrease of antithrombin III, plasminogen, protein C, protein S and increase of prothrombin fragment F1 + 2, thrombin-antithrombin complexes and fibrinopeptide A). The aim of this study was to determine whether the supplementation of antithrombin III (AT-III) concentrates could improve the L-asparaginase associated coagulopathy, thereby blocking the activation of the haemostatic system. In 25 adult patients with acute lymphoblastic leukaemia (M 19, F6, mean age 34 years) antithrombin III (AT-III) concentrates were administered at daily doses of 50 U/kg for 10 consecutive days from the beginning of L-asparaginase therapy (6,000 U/m2/day s.c. for 7 days), given according to the GIMEMA ALL 0288 trial. A marked increase of antithrombin III was recorded on days IV-VIII-XI (P < 0.001). No changes in protein C, protein S, plasminogen, alpha 2-antiplasmin, factor VII and platelet count were observed and there was no increase in markers of hypercoagulability. There was no evidence of disseminated intravascular coagulation. In conclusion, AT-III concentrate supplementation during L-asparaginase therapy, by the achievement of high levels of antithrombin III, is associated with a lack of activation of the haemostatic system and appears to overcome the complex coagulopathy associated with L-asparaginase.
1994
01 Pubblicazione su rivista::01a Articolo in rivista
ANTITHROMBIN III INFUSION SUPPRESSES THE HYPERCOAGULABLE STATE IN ADULT ACUTE LYMPHOBLASTIC LEUKAEMIA PATIENTS TREATED WITH A LOW-DOSE OF ESCHERICHIA COLI L-ASPARAGINASE. A GIMEMA STUDY / Mazzucconi, Maria Gabriella; Gugliotta, L; Leone, G; Dragoni, F; MATTIOLI BELMONTE, M; DE STEFANO, V; Chistolini, A; Tura, S; Mandelli, F.. - In: BLOOD COAGULATION & FIBRINOLYSIS. - ISSN 0957-5235. - 5:(1994), pp. 23-28. [10.1097/00001721-199402000-00004]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/89112
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