在一项机构队列研究中,天冬酰胺酶治疗期间获得性凝血因子缺陷。

IF 2.1 Q3 HEMATOLOGY
Journal of Blood Medicine Pub Date : 2023-11-07 eCollection Date: 2023-01-01 DOI:10.2147/JBM.S428159
Vasiliki Papadopoulou, Giulia Schiavini
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引用次数: 0

摘要

在我们的临床实践中,我们总是看到使用天冬酰胺酶治疗的患者活化部分凝血活酶时间的延长,但我们注意到,与低纤维蛋白原血症和低抗凝血酶相反,天冬酰胺酶延长凝血时间在文献和指南中基本上没有报道,临床医生也不广泛了解。我们报告了一小群患者的aPTT延长,以及它们的起源,通过测量天冬酰胺酶给药前后的凝血因子、纤维蛋白原和d -二聚体来调查。我们观察到FIX和FXI显著降低(治疗后中位值分别为27 IU/dl和52 IU/dl),证实了先前的一个观察结果。FXII的减少不太明显,但有助于延长aptt (FXII对体内止血没有影响)。正如d -二聚体水平不变所证明的那样,因子缺乏不是由于消耗,因此可能是由因子合成紊乱引起的。我们的观察和见解有助于阐明天冬酰胺酶治疗期间凝血测定的概况,从而最佳地监测不良事件或引导治疗抗凝的情况,而不会出现次优或过度抗凝的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Acquired Clotting Factor Deficits During Treatment with Asparaginase in an Institutional Cohort.

We invariably see prolongation of activated partial thromboplastin time in patients treated with asparaginase in our clinical practice, but have noted that, contrary to hypofibrinogenemia and low antithrombin, clotting times' prolongation by asparaginase is largely unreported in the literature and guidelines and is not widely known to clinicians. We report on aPTT prolongations in a small cohort of patients, and on their origin, as investigated by measurements of clotting factors, fibrinogen, and D-dimers before and after asparaginase administration. We observed significant reductions in FIX and FXI (median post-treatment values of 27 IU/dl and 52 IU/dl, respectively), confirming one previous observation. A decrease in FXII was less pronounced but contributed to the prolonged aPTTs (FXII has no effect on in vivo haemostasis). The factor deficits are not due to consumption, as evidenced by unchanged D-dimer levels, and are, therefore, probably caused by disturbed factor synthesis. Our observations and insights contribute to elucidation of the profile of clotting assays during asparaginase treatment, and thus, to optimally monitor for undesirable events or steer situations of therapeutic anticoagulation without the risk of suboptimal or excessive anticoagulation.

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来源期刊
CiteScore
3.50
自引率
0.00%
发文量
94
审稿时长
16 weeks
期刊介绍: The Journal of Blood Medicine is an international, peer-reviewed, open access, online journal publishing laboratory, experimental and clinical aspects of all topics pertaining to blood based medicine including but not limited to: Transfusion Medicine (blood components, stem cell transplantation, apheresis, gene based therapeutics), Blood collection, Donor issues, Transmittable diseases, and Blood banking logistics, Immunohematology, Artificial and alternative blood based therapeutics, Hematology including disorders/pathology related to leukocytes/immunology, red cells, platelets and hemostasis, Biotechnology/nanotechnology of blood related medicine, Legal aspects of blood medicine, Historical perspectives. Original research, short reports, reviews, case reports and commentaries are invited.
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