Prophylaxis with enoxaparin and antithrombin III in drug-induced coagulation alterations in childhood leukemia: a retrospective experience of 20 years.
Christina Salvador, Robert Salvador, Gabriele Kropshofer, Bernhard Meister, Marie Rock, Petra Obexer, Benjamin Hetzer, Evelyn Rabensteiner, Roman Crazzolara
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引用次数: 0
Abstract
Background: Thromboembolic complications are well known in the treatment of childhood acute lymphoblastic leukemia. Over the years it has not been possible to reach a consensus on a possible prophylaxis of thromboembolic events during intensive therapy. Only the administration of enoxaparin was able to achieve evidence in the literature to date.
Methods: In this retrospective study, 173 childhood leukemia patients were treated over 20 years with a thromboembolic prophylaxis including enoxaparin and AT III during induction therapy with L-asparaginase and cortisone.
Results: We here report the effectiveness of administration of enoxaparin and AT III in childhood leukemia, showing a strikingly low prevalence of deep vein thrombosis (2.9%). Especially in adolescent patients, a particularly great need for AT III was demonstrated.
Conclusions: We recommend thromboembolic prophylaxis with enoxaparin and AT III substitution during induction/reinduction therapy with L-asparaginase and glucocorticosteroids, especially from adolescence onwards.
背景：血栓栓塞并发症在儿童急性淋巴细胞白血病的治疗中是众所周知的。多年来，人们一直未能就强化治疗期间预防血栓栓塞事件的可能性达成共识。迄今为止，只有服用依诺肝素能够在文献中获得证据：在这项回顾性研究中，173 名儿童白血病患者在接受 L-天冬酰胺酶和可的松诱导治疗期间接受了长达 20 年的血栓栓塞预防治疗，包括依诺肝素和 AT III：我们在此报告在儿童白血病患者中使用依诺肝素和 AT III 的效果，结果显示深静脉血栓的发生率非常低（2.9%）。结论：我们建议儿童白血病患者进行血栓栓塞预防：我们建议在使用 L-天冬酰胺酶和糖皮质激素进行诱导/还原治疗期间，使用依诺肝素和 AT III 进行血栓栓塞预防，尤其是从青春期开始。
期刊介绍：
Thrombosis Journal is an open-access journal that publishes original articles on aspects of clinical and basic research, new methodology, case reports and reviews in the areas of thrombosis.
Topics of particular interest include the diagnosis of arterial and venous thrombosis, new antithrombotic treatments, new developments in the understanding, diagnosis and treatments of atherosclerotic vessel disease, relations between haemostasis and vascular disease, hypertension, diabetes, immunology and obesity.
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