Hong De Sa,Thomas Deloughery,Andy Kaempf,Curtis Lachowiez,Jessica Leonard,Rick Mathews,Shauna Rakshe,Joseph J Shatzel,Ronan Swords,Elie Traer,Brandon Hayes-Lattin
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引用次数: 0
摘要
接受天冬酰胺酶(ASP)治疗急性淋巴细胞白血病(ALL)的年轻成人血栓形成率高达34%,其中诱导期风险最高。我们所在的机构对在诱导期间接受天冬酰胺酶治疗的年轻成人急性淋巴细胞白血病患者实施了1毫克/千克/天依诺肝素的标准治疗。我们对俄勒冈健康与科学大学 2012 年至 2023 年期间在含 ASP 诱导治疗 ALL 期间接受 1 mg/kg/day 依诺肝素血栓预防治疗的患者进行了回顾性分析。主要结果是诱导期间血栓形成的累积发生率。对出血事件进行了评估。我们的分析纳入了 62 例患者。四名患者(6.5%;95% CI 1.8%-15.7%)发生了血栓事件。其中三起与导管有关,一起是与肌炎有关的下肢远端深静脉血栓。没有发生脑窦血栓、血栓相关死亡或大出血事件。中剂量依诺肝素是一种很有前景的血栓预防策略,值得进一步开展前瞻性研究。
Thromboprophylaxis with intermediate dose enoxaparin during asparaginase containing induction for young adults with acute lymphoblastic leukemia.
Thrombosis rates among young adults receiving asparaginase (ASP) for acute lymphoblastic leukemia (ALL) can reach 34%, with highest risk during induction. Our institution implemented a standard practice of 1 mg/kg/day enoxaparin administered to young adults with ALL who are treated with ASP during induction. We performed a retrospective analysis of patients who received thromboprophylaxis with enoxaparin 1 mg/kg/day during ASP-containing induction for ALL at Oregon Health & Science University from 2012 to 2023. The primary outcome was the cumulative incidence of thrombosis during induction. Bleeding events were assessed. Sixty-two patients were included in our analysis. Four patients (6.5%; 95% CI 1.8%-15.7%) experienced a thrombotic event. Three events were catheter-associated and 1 event was a distal lower extremity deep vein thrombosis related to myositis. No cerebral sinus thromboses, thrombosis-related deaths or major bleeding events occurred. Intermediate-dose enoxaparin is a promising thromboprophylaxis strategy and warrants further prospective research.
期刊介绍:
Leukemia & Lymphoma in its fourth decade continues to provide an international forum for publication of high quality clinical, translational, and basic science research, and original observations relating to all aspects of hematological malignancies. The scope ranges from clinical and clinico-pathological investigations to fundamental research in disease biology, mechanisms of action of novel agents, development of combination chemotherapy, pharmacology and pharmacogenomics as well as ethics and epidemiology. Submissions of unique clinical observations or confirmatory studies are considered and published as Letters to the Editor