All issues > Volume 42(11); 1999

Original Article

J Korean Pediatr Soc. 1999;42(11):1567-1573. Published online November 15, 1999.

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

Jeong Ah JA Choi¹, Young Tak YT Lim¹

¹Department of Pediatrics, College of Medicine, Pusan National University, Pusan, Korea

Correspondence Jeong Ah JA Choi ,Email: 1

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.

Keywords :L-asparaginase, Antithrombin Ⅲ