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Antithrombin supplementation III in childhood acute lymphoblastic leukemia treated with L-asparaginase
Insights
Supplementing antithrombin III (AT) concentrates effectively boosted AT levels in children with acute lymphoblastic leukemia (ALL) treated with L-asparaginase (ASP). This AT supplementation may help reduce the risk of blood clots.
Area of Science:
- Pediatric Hematology
- Oncology
- Pharmacology
Background:
- L-asparaginase (ASP) therapy in acute lymphoblastic leukemia (ALL) can lead to acquired antithrombin III (AT) deficiency.
- This deficiency increases the risk of thrombosis in pediatric patients.
Discussion:
- This study evaluated the efficacy of antithrombin III (AT) concentrate supplementation in ALL children with acquired AT deficiency post-ASP administration.
- Patients received AT concentrates at a dose of 34.5 +/- 7.6 U/kg.
- Plasma AT activity and antigen levels increased significantly post-infusion.
Key Insights:
- Infusion of AT concentrates resulted in a predictable increase in plasma AT activity and antigen levels.
- The increase was approximately 2.07 +/- 0.62% for activity and 0.70 +/- 0.16 mg/dL for antigen per unit of AT infused per kilogram of body weight.
- AT levels decreased to 62.0 +/- 7.7% of peak values within 48 hours, indicating a transient but significant effect.
Outlook:
- Consistent administration of AT concentrates effectively raised plasma AT activity in ALL children undergoing ASP treatment.
- This intervention shows potential in mitigating the acquired prothrombotic state associated with ASP therapy.
- Further research could explore optimal dosing and long-term prophylactic strategies.
Abstract:
The change of plasma antithrombin III (AT) levels after supplementation of AT concentrates was examined in ALL children with acquired AT deficiency following L-asparaginase (ASP) administration. The patients received AT concentrates of 34.5 +/- 7.6 U/kg. The increase of plasma AT activity and antigen was 2.07 +/- 0.62% and 0.70 +/- 0.16 mg/dL per unit AT infused per kilogram of body weight, respectively. The activity decreased to 62.0 +/- 7.7% of the peak values by 48 hours after supplementation. The administration of AT concentrates constantly increased the plasma AT activity in ALL children treated with ASP, which may minimize the acquired prothrombotic state.