Ad. Shapiro et al., THROMBOSIS IN CHILDREN RECEIVING L-ASPARAGINASE - DETERMINING PATIENTS AT RISK, The American journal of pediatric hematology/oncology, 15(4), 1993, pp. 400-405
Purpose: A prospective study of coagulation in 15 children who receive
d L-asparaginase, vincristine, or prednisone plus or minus an anthracy
cline as part of a treatment program for leukemia or leukemia-lymphoma
syndrome was conducted.Patients and Methods: One patient developed a
central nervous system thrombosis. Results: The inhibitors of coagulat
ion, including antithrombin-III, protein C, protein S, and plasminogen
, were decreased in many individuals, but were not significantly diffe
rent in the patient who had experienced the thrombotic event. Platelet
aggregations to low molar ADP were performed in four patients, and in
three patients showed a hyperaggregable pattern. Conclusions: The pat
ient with thrombosis developed a transient acquired type II pattern on
multimeric analysis of the von Willebrand factor, which was not seen
in the other individuals studied.