Hemostatic Changes and Effect of Antithrombin III Replacement Therapy in Children with Acute Lymphoblastic Leukemia

Choi, Jeong Ah; Lim, Young Tak

Abstract

PURPOSE: We evaluated plasma coagulation parameters sequentially and the influence of antithrombin III adjuvant treatment in children with acute lymphoblastic leukemia.
METHODS
Twenty-nine cases with acute lymhoblastic leukemia who had been treated with L-asparaginase at Pusan National University Hospital were enrolled in this study. The coagulation parameters were checked before and on every week of L-asparaginase administration. The patients whose level of antithrombin III was below normal range were given antithrombin III done adjuvant treatment.
RESULTS
In the twenty-nine cycles of chemotherapies, nine cycles were treated with antithrombin III adjuvant therapy and others were not treated with the therapy. The PT and aPTT levels showed no changes during L-asparaginase treatment. After one week of L-asparaginase treatment, the fibrinogen and antithrombin III levels were decreased markedly. Antithrombin III level in patients under antithrombin III adjuvant treatment had increased significantly. On the other hand, antithrombin III level in patients not on antithrombin III adjuvant treatment showed low levels until finishing L-asparaginase. We observed only one case of sudden cerebral thrombosis in the non-antithrombin III adjuvant treatment.
CONCLUSION
Antithrombin III adjuvant treatment can correct hemostatic parameters partially and may prevent thromboembolic events in patients with L-asparaginase.