LEJHANCOVÁ-TOUŠOVSKÁ, Kateřina, Ondřej ZAPLETAL, Soňa VYTISKOVÁ, Petra STRBÁČKOVÁ and Jaroslav ŠTĚRBA. Profile of thrombin generation in children with acute lymphoblastic leukemia treated by Berlin - Frankfurt-Münster (BFM) protokols. Blood Coagulation and Fibrinolysis. 2012, vol. 23, No 2, p. 144-154. ISSN 0957-5235. Available from: https://dx.doi.org/10.1097/MBC.0b013e32834fb539.
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Basic information
Original name Profile of thrombin generation in children with acute lymphoblastic leukemia treated by Berlin - Frankfurt-Münster (BFM) protokols
Authors LEJHANCOVÁ-TOUŠOVSKÁ, Kateřina, Ondřej ZAPLETAL, Soňa VYTISKOVÁ, Petra STRBÁČKOVÁ and Jaroslav ŠTĚRBA.
Edition Blood Coagulation and Fibrinolysis, 2012, 0957-5235.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30200 3.2 Clinical medicine
Country of publisher United States of America
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 1.248
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1097/MBC.0b013e32834fb539
UT WoS 000300124900006
Keywords in English acute lymphoblastic leukemia; chemotherapy; pediatric hematology/oncology; thrombin generation; thrombosis
Tags International impact
Changed by Changed by: RNDr. Soňa Vytisková, Ph.D., učo 21476. Changed: 1/11/2016 08:23.
Abstract
Treatment with L-asparaginase is associated with coagulation disturbances with deep venous thrombosis being the most common clinical consequence. Use of the calibrated automated thrombogram allows precise estimation of thrombin generated in vitro. We show the first data on thrombin generation, measured by calibrated automated thrombography (CAT), in children with acute lymphoblastic leukemia treated with L-asparaginase. Thrombin generation was measured by means of CAT in 23 children treated for acute lymphoblastic leukemia. Samples were obtained at predefined time points during the induction and reinduction phase of acute lymphoblastic leukemia-intercontinental Berlin-Frankfurt-Munster (BFM) 2000 or Associazione Italiana Ematologica Oncologia Pedaitrica Interim BFM 2000 protocols. Antihrombin and fibrinogen were measured on the same sample. Twenty-eight sets of thrombin generation measurements were collected from 23 patients. We observed no significant effect of antithrombin deficiency and/or hypofibrinogenemia on thrombin generation. Endogenous thrombin generation and peak thrombin were significantly higher during induction than in the reinduction phase (P<0.001). Four patients with severe infection experienced an increase in thrombin generation, reaching maximum in a median of 7.5 days after the onset of infection. Two of those patients developed deep venous thrombosis at the time of peaked endogenous thrombin generation. Thrombin generation in children with acute lymphoblastic leukemia treated according to BFM protocols is significantly higher during the induction phase compared with reinduction and is not substantially affected by hypofibrinogenemia and/or antithrombin deficiency. Severe infection during the induction phase enhances thrombin generation with subsequent risk of thrombosis.
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