HEMOSTATIC CHANGES IN PATIENTS WITH ACUTE LYMPHOBLASTIC-LEUKEMIA DURING AND AFTER REMISSION INDUCTION THERAPY

Haemostatic parameters were studied in 14 adult patients treated for a cute lymphoblastic leukaemia (ALL). Significant changes in haemostasis occurred during combination chemotherapy only in association with the application of L-asparaginase (L-Asp). The only exception was decreas ed level of protein C (PC) in response to daunomycine and vincristine alone on day 4 (p<0.05). Significantly lower values of PC, antithrombi n III, alpha 2 antiplasmin, fibrinogen, plasminogen (Plg), and higher levels of fibrinopeptide A (FPA), tissue plasminogen activator antigen (t-PA:Ag) and plasminogen activator inhibitor (PAI) activity were see n during L-Asp therapy with maximum on days 20 and 23 of combination c hemotherapy (day 4 and 7 of L-Asp treatment) (p<0.05). Significantly i ncreased levels of PAI and FPA and decreased levels of Plg were also f ound after the cessation of L-Asp, with maximum on day 37 (day 9 after the discontinuation of L-Asp) (p<0.05). Prealbumin decreased after L- Asp with maximum on day 30 (p<0.05), transferrin on day 37 (p<0.05). L iver function tests (AST, ALT, ALP, GMT) were abnormal with peak value s after the cessation of L-Asp (NS). In spite of present changes the h aemostatis was compensated, and the observed changes, though statistic ally significant, were not clinically significant.