ENHANCED THROMBIN GENERATION, P-VON-WILLEBRAND-FACTOR, P-FIBRIN D-DIMER AND P-PLASMINOGEN ACTIVATOR INHIBITOR-1 - PREDICTIVE FOR VENOUS THROMBOSIS IN ASPARAGINASE-TREATED CHILDREN

Hypercoagulability and thrombosis are reported side effects of leukemi a treatment with L-asparaginase (l-asp), To determine haemostatic risk parameters for venous thrombosis parameters of coagulation and fibrin olysis were investigated prior and in the follow-up of I-asp infusion in 46 children (ALL-BFM 90 study) in a prospective two-center study. P -Fibrinogen, P-Antithrombin, P-Protein C, P-Plasminogen and P-Plasmin inhibitor were diminished in all children. Seven patients (15%) develo ped thrombosis. Prior to these thrombotic events P-Prothrombin fragmen t 1+2, P-Fibrin D-dimers, P-vWF and P-Plasminogen activator inhibitor 1 were enhanced to values significantly higher than in leukemia patien ts without thrombosis. Additionally three patients showed unusually la rge multimers. Our results show elevated P-vWF, P-Plasminogen activato r inhibitor 1, P-Prothrombin fragment F1+2 and P-Fibrin D-dimer to be predictive (specificity 71%) for venous occlusion in asp-treated leuke mic children.