Acquired antithrombin III deficiency secondary to asparaginase therapy in childhood acute lymphoblastic leukaemia

As improved treatment regimens for acute lymphoblastic leukaemia (ALL) continue to improve survival future, therapy must also take into consideration the many secondary problems. Most of these are the direct result of combination chemotherapy and L-asparaginase (ASP), is an example of a highly effective chemotherapeutic agent with serious side-effects such as thromboembolic events. ASP interferes with protein synthesis resulting in an acquired deficiency of antithrombin III. This review explores the effects of ALL and ASP on haemostasis, and the link between ASP and thromboembolic events in childhood ALL.