The frequency and management of asparaginase‐related thrombosis in paediatric and adult patients with acute lymphoblastic leukaemia treated on Dana‐Farber Cancer Institute consortium protocols
書誌事項
- 公開日
- 2011-01-07
- 権利情報
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- http://onlinelibrary.wiley.com/termsAndConditions#vor
- DOI
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- 10.1111/j.1365-2141.2010.08524.x
- 公開者
- Wiley
この論文をさがす
説明
<jats:title>Summary</jats:title><jats:p>The optimal management of asparaginase‐associated thrombotic complications is not well‐defined. We report the features, management and outcome of paediatric (ages 0–18 years) and adult (18–50 years) patients with acute lymphoblastic leukaemia (ALL) with asparaginase‐related venous thromboembolic events (VTE) treated at Dana‐Farber Cancer Institute on clinical trials for newly diagnosed ALL between 1991–2008. Of 548 patients, 43 (8%) had VTE, including 27/501 (5%) paediatric and 16/47 (34%) adult patients. Sinus venous thrombosis occurred in 1·6% of patients. Age was the only significant predictor of VTE, with those aged >30 years at very high risk (VTE rate 42%). 74% of patients received low molecular weight heparin after VTE. Complications of anticoagulation included epistaxis (9%), bruising (2%) and, in two adult patients, major bleeding. Thirty patients (70%) ultimately received at least 85% of the intended doses of asparaginase. 33% of patients experienced recurrent VTE (paediatric 17% vs. adults 47%, <jats:italic>P</jats:italic> = 0·07). The 48‐month event‐free survival for patients with VTE was 85 ± 6% compared with 88 ± 2% for those without VTE (<jats:italic>P</jats:italic> = 0·36). This study confirms that, after VTE, asparaginase can be restarted with closely monitored anticoagulation after imaging demonstrates clot stabilization or improvement. With this management strategy, a history of VTE does not appear to adversely impact prognosis.</jats:p>
収録刊行物
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- British Journal of Haematology
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British Journal of Haematology 152 (4), 452-459, 2011-01-07
Wiley
