PMID- 2189489
OWN - NLM
STAT- MEDLINE
DCOM- 19900711
LR  - 20190704
IS  - 0007-1048 (Print)
IS  - 0007-1048 (Linking)
VI  - 74
IP  - 4
DP  - 1990 Apr
TI  - Hypercoagulability during L-asparaginase treatment: the effect of antithrombin 
      III supplementation in vivo.
PG  - 465-70
AB  - To evaluate the occurrence of hypercoagulability during treatment with 
      L-asparaginase (L-ase), thrombin-antithrombin complex (TAT) and D-dimer levels in 
      plasma were serially measured in 15 consecutive adult patients with acute 
      lymphoblastic leukaemia or lymphoblastic lymphoma who had recently completed a 
      chemotherapy cycle with cytosine arabinoside and methotrexate. The first eight 
      patients (group A) received i.v. L-ase alone (20,000 U/m2 on alternate days over 
      10 d); the last seven patients (group B) received, in addition to L-ase, bolus 
      injection of antithrombin concentrate (2000 U) on alternate days for a total of 
      six administrations, beginning with the second L-ase infusion. Increased levels 
      of TAT (P less than 0.05) and D-dimer (P less than 0.01) were observed prior to 
      L-ase, possibly related to inflammation and cytolysis secondary to previous 
      chemotherapy. In patients treated with L-ase alone, further elevation of TAT (P 
      less than 0.05) and persistence of increased D-dimer were observed, associated 
      with marked reduction of the anticoagulant activities of protein C, protein S and 
      antithrombin III. At variance, in patients receiving antithrombin III 
      supplementation there was no increase of TAT and a normalization of D-dimer 
      levels occurred during L-ase treatment. In these patients, mean plasma 
      antithrombin III activity was maintained at levels higher than 70% of normal 
      throughout the treatment. The rate of decline of fibrinogen, factor IX, protein C 
      and protein S was unaffected by antithrombin III supplementation, indicating that 
      hypercoagulability has little if any relevance for the reduction of coagulation 
      factors and inhibitors induced by L-ase treatment. The usefulness of antithrombin 
      III concentrates in preventing thromboembolic complications in patients submitted 
      to L-ase treatment remains to be determined.
FAU - Gugliotta, L
AU  - Gugliotta L
AD  - Istituto di Ematologia L.eA.Seragnoli, University of Bologna, Italy.
FAU - D'Angelo, A
AU  - D'Angelo A
FAU - Mattioli Belmonte, M
AU  - Mattioli Belmonte M
FAU - Vigano-D'Angelo, S
AU  - Vigano-D'Angelo S
FAU - Colombo, G
AU  - Colombo G
FAU - Catani, L
AU  - Catani L
FAU - Gianni, L
AU  - Gianni L
FAU - Lauria, F
AU  - Lauria F
FAU - Tura, S
AU  - Tura S
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Br J Haematol
JT  - British journal of haematology
JID - 0372544
RN  - 0 (antithrombin III-protease complex)
RN  - 9000-94-6 (Antithrombin III)
RN  - EC 3.4.- (Peptide Hydrolases)
RN  - EC 3.5.1.1 (Asparaginase)
SB  - IM
MH  - Antithrombin III/metabolism/*therapeutic use
MH  - Asparaginase/*adverse effects/therapeutic use
MH  - Blood Coagulation Disorders/chemically induced/*prevention & control
MH  - Humans
MH  - Lymphoma, Non-Hodgkin/blood/drug therapy
MH  - Peptide Hydrolases/metabolism
MH  - Precursor Cell Lymphoblastic Leukemia-Lymphoma/blood/drug therapy
EDAT- 1990/04/01 00:00
MHDA- 1990/04/01 00:01
CRDT- 1990/04/01 00:00
PHST- 1990/04/01 00:00 [pubmed]
PHST- 1990/04/01 00:01 [medline]
PHST- 1990/04/01 00:00 [entrez]
AID - 10.1111/j.1365-2141.1990.tb06336.x [doi]
PST - ppublish
SO  - Br J Haematol. 1990 Apr;74(4):465-70. doi: 10.1111/j.1365-2141.1990.tb06336.x.