Titre
Acquired Clotting Factor Deficits During Treatment with Asparaginase in an Institutional Cohort.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Papadopoulou, V.
Auteure/Auteur
Schiavini, G.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1179-2736
Statut éditorial
Publié
Date de publication
2023
Volume
14
Première page
569
Dernière page/numéro d’article
574
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Case Reports
Publication Status: epublish
Publication Status: epublish
Résumé
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.
PID Serval
serval:BIB_CD4C2B9C285F
PMID
Open Access
Oui
Date de création
2023-11-16T13:35:45.084Z
Date de création dans IRIS
2025-05-20T21:21:07Z
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Nom
37965639_BIB_CD4C2B9C285F.pdf
Version du manuscrit
published
Licence
https://creativecommons.org/licenses/by/4.0
Taille
397.19 KB
Format
Adobe PDF
PID Serval
serval:BIB_CD4C2B9C285F.P001
URN
urn:nbn:ch:serval-BIB_CD4C2B9C285F6
Somme de contrôle
(MD5):cfd1ffbdaf67a67c0d44d73cf8aba222