The use of prophylactic anticoagulation during induction and consolidation chemotherapy in adults with acute lymphoblastic leukemia

被引:32
|
作者
Grace, Rachael F. [1 ,2 ]
DeAngelo, Daniel J. [2 ,3 ]
Stevenson, Kristen E. [4 ]
Neuberg, Donna [4 ]
Sallan, Stephen E. [1 ,2 ]
Abou Mourad, Yasser R. [5 ,6 ]
Bergeron, Julie [7 ]
Seftel, Matthew D. [8 ]
Kokulis, Caroline [3 ]
Connors, Jean M. [2 ,9 ]
机构
[1] Dana Farber Boston Childrens Canc & Blood Disorde, Pediat Hematol Oncol, 450 Brookline Ave,D3-106, Boston, MA 02450 USA
[2] Harvard Med Sch, Boston, MA 02115 USA
[3] Dana Farber Canc Inst, Dept Med Oncol, Boston, MA 02115 USA
[4] Dana Farber Canc Inst, Biostat & Computat Biol, Boston, MA 02115 USA
[5] Vancouver Gen Hosp, Leukemia BMT Program British Columbia, Vancouver, BC, Canada
[6] Univ British Columbia, Vancouver, BC, Canada
[7] Univ Montreal, CIUSSS Est de Ile de Montreal, Installat Maisonneuve Rosemont, Montreal, PQ, Canada
[8] CancerCare Manitoba, Dept Med Oncol Hematol, Winnipeg, MB, Canada
[9] Brigham & Womens Hosp, Dept Hematol, Dana Farber Canc Inst, 75 Francis St, Boston, MA 02115 USA
关键词
Acute lymphoblastic leukemia; Asparaginase; Thrombosis; Anticoagulation; L-ASPARAGINASE TREATMENT; VENOUS THROMBOEMBOLISM; THROMBIN GENERATION; CANCER-PATIENTS; CHILDREN; THERAPY; RISK; PREVENTION;
D O I
10.1007/s11239-017-1597-7
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Treatment for acute lymphoblastic leukemia (ALL) in adults confers a high risk of venous thromboembolic (VTE) complications. We describe the implementation and results of prophylactic anticoagulation guidelines in adults (18-50 years) treated on a Dana-Farber Cancer Institute ALL pediatric inspired consortium protocol from 2007 to 2013. A high rate of asparaginase related toxicity events, including thrombosis, resulted in a protocol amendment adding guidelines for prophylactic anticoagulation and a modified asparaginase dose and schedule. After excluding patients with Philadelphia positive ALL, a cohort of 36 patients were treated after the protocol amendment with prophylactic anticoagulation and compared to 49 patients who received no prophylactic anticoagulation. Bleeding complications were not significantly different in those treated with prophylactic anticoagulation compared with those enrolled prior to the amendment (p = 0.26). No patients on prophylactic anticoagulation had grade >= 3 bleeding. Prior to the amendment, the 2 year cumulative incidence of VTE post-induction was 41% compared to 28% while on prophylactic anticoagulation (p = 0.32). The 2 year cumulative incidence pulmonary embolus pre-amendment was 16% compared with 8% post-amendment (p = 0.34). Prophylactic anticoagulation can be safely administered to adults with ALL without increasing the number or severity of bleeding events and, in addition to modifications in the asparaginase regimen, resulted in a reduction in the cumulative incidence of VTE.
引用
收藏
页码:306 / 314
页数:9
相关论文
共 50 条
  • [1] The use of prophylactic anticoagulation during induction and consolidation chemotherapy in adults with acute lymphoblastic leukemia
    Rachael F. Grace
    Daniel J. DeAngelo
    Kristen E. Stevenson
    Donna Neuberg
    Stephen E. Sallan
    Yasser R. Abou Mourad
    Julie Bergeron
    Matthew D. Seftel
    Caroline Kokulis
    Jean M. Connors
    [J]. Journal of Thrombosis and Thrombolysis, 2018, 45 : 306 - 314
  • [2] TREATMENT OF ACUTE LYMPHOBLASTIC-LEUKEMIA IN ADULTS WITH INTENSIVE INDUCTION, CONSOLIDATION, AND MAINTENANCE CHEMOTHERAPY
    HUSSEIN, KK
    DAHLBERG, S
    HEAD, D
    WADDELL, CC
    DABICH, L
    WEICK, JK
    MORRISON, F
    SAIKI, JH
    METZ, E
    RIVKIN, SE
    GREVER, MR
    BOLDT, D
    [J]. BLOOD, 1989, 73 (01) : 57 - 63
  • [3] Nutritional state alterations in children with acute lymphoblastic leukemia during induction and consolidation of chemotherapy
    MejiaArangure, JM
    FajardoGutierrez, A
    BernaldezRios, R
    RodriguezZepeda, MDC
    EspinozaHernandez, L
    MartinezGarcia, MDC
    [J]. ARCHIVES OF MEDICAL RESEARCH, 1997, 28 (02): : 273 - 279
  • [4] Prophylactic Use of Levofloxacin Leads to Reduction in the Febrile Neutropenia Episodes During Induction Chemotherapy in Children of Acute Lymphoblastic Leukemia and Lymphoblastic Lymphoma
    Rehman, P.
    Wali, R.
    Saeed, H.
    Shaheen, N.
    Ishaq, I.
    Raza, A.
    Javed, S.
    Anjum, S.
    Shaukat, Z.
    Khan, S.
    [J]. PEDIATRIC BLOOD & CANCER, 2021, 68 : S192 - S192
  • [5] TREATMENT OF ACUTE LYMPHOBLASTIC-LEUKEMIA (ALL) IN ADULTS USING INTENSIVE INDUCTION, CONSOLIDATION AND MAINTENANCE CHEMOTHERAPY
    WADDELL, CC
    HUSSEIN, KK
    HEAD, DR
    [J]. PROCEEDINGS OF THE AMERICAN ASSOCIATION FOR CANCER RESEARCH, 1983, 24 (MAR): : 116 - 116
  • [6] A randomized controlled trial of filgrastim during remission induction and consolidation chemotherapy for adults with acute lymphoblastic leukemia: CALGB study 9111
    Larson, RA
    Dodge, RK
    Linker, CA
    Stone, RM
    Powell, BL
    Lee, EJ
    Schulman, P
    Davey, FR
    Frankel, SR
    Bloomfield, CD
    George, SL
    Schiffer, CA
    [J]. BLOOD, 1998, 92 (05) : 1556 - 1564
  • [7] Urolithiasis in an acute lymphoblastic leukemia child during induction chemotherapy
    Shiozawa, Yusuke
    Sakaguchi, Sachi
    Sakakibara, Oto
    Yagishita, Keiko
    Saito, Masahiro
    Yamashiro, Yuichiro
    [J]. PEDIATRIC HEMATOLOGY AND ONCOLOGY, 2008, 25 (04) : 359 - 363
  • [8] Characterization of Pediatric Patients with Acute Lymphoblastic Leukemia and Hepatotoxicity during Induction and Consolidation
    Navai, S.
    Hashmi, S.
    Rau, R.
    Gramatges, M.
    [J]. PEDIATRIC BLOOD & CANCER, 2018, 65 : S145 - S145
  • [9] Coagulation profile during induction chemotherapy in childhood acute lymphoblastic leukemia
    Sehgal, Shivali
    Sharma, Sunita
    Chandra, Jagdish
    Nangia, Anita
    [J]. INDIAN JOURNAL OF PATHOLOGY AND MICROBIOLOGY, 2017, 60 (01) : 50 - 56
  • [10] Encephalopathy and brain atrophy during induction chemotherapy in acute lymphoblastic leukemia
    Li, Qiao-Ru
    Fu, Si-Mao
    Mo, Yin-Lei
    Li, Yu
    Liang, Cong
    Wang, Li-Na
    Tang, Wen-Yan
    Huang, Li-Bin
    Luo, Xue-Qun
    Tang, Yan-Lai
    [J]. CLINICAL CASE REPORTS, 2020, 8 (09): : 1858 - 1859