Asparaginase administration in children suffering from acute lymphoblastic leukemia

C. Wermes; R. Schobess; S. Halimeh; W. Nürnberger; A. Kosch; U. Nowak-Göttl

doi:10.1055/s-0037-1619483

Hämostaseologie, Inhaltsverzeichnis

Hamostaseologie 2000; 20(03): 151-153
DOI: 10.1055/s-0037-1619483

Original article

Schattauer GmbH

Asparaginase administration in children suffering from acute lymphoblastic leukemia

A systematic overview of the literatureAsparaginasegabe bei Kindern mit akuter lymphoblastischer LeukämieEine Literaturübersicht

C. Wermes

¹Department of Hematology/Oncology, University of Hanover, Germany

,

R. Schobess

²Department of Pediatric Hematology/Oncology, University of Halle, Germany

,

S. Halimeh

³Department of Pediatric Hematology/Oncology, University of Münster, Germany

,

W. Nürnberger

⁴Department of Pediatric Hematology/Oncology, University of Düsseldorf, Germany

,

A. Kosch

³Department of Pediatric Hematology/Oncology, University of Münster, Germany

,

U. Nowak-Göttl

³Department of Pediatric Hematology/Oncology, University of Münster, Germany

› Institutsangaben

Abstract

Summary

Background: Previous studies focusing on asparaginase(ASP)-induced acquired alterations of the hemostatic system reported in childhood acute lymphoblastic leukemia (ALL) could not sufficiently explain the sporadic manifestations of thrombotic events in the studied populations, reported as between 0.8% and 11%. Therefore the present retrospective overview was conducted to unravel the possible interaction between prothrombotic risk factors, leukemia protocols and the concomitant use of different anti-leukemic agents with respect to the presence of symptomatic venous vascular accidents. Methods: Published reports on childhood leukemia and hemostatic alterations (no case-reports) obtained from a Medline-based search (1980-2000) were included in the present overview. Conclusions: Based on the data presented here, evidence is given that the wide range of thrombotic events reported is due mainly to different study designs, prospective versus retrospective data, E. coli ASP sources of different origin (Erwinia, E. coli A, E. coli B) and dosages, administered alone or in combination with steroids, as well as a variable number of patients included in the studies reported.

Zusammenfassung

Hintergrund: Zahlreiche Studien über Asparaginase (ASP)-induzierte Gerinnungsstörungen bei akuter lymphoblastischer Leukämie (ALL) im Kindesalter konnten die berichtete symptomatische Thromboserate zwischen 0.8% und 11% nicht hinreichend erklären. Daher haben wir hier die bisher publizierten pädiatrischen Daten in einer Übersicht zusammengestellt und versucht, eine mögliche Erklärung für die unterschiedlich berichteten Thromboseraten abzuleiten. Methoden: Arbeiten (keine Falldarstellungen) zwischen 1980 und 2000 (Medline) wurden berücksichtigt. Schlussfolgerungen: Auf Grund der hier zusammengefassten Daten postulieren wir, dass die unterschiedliche Thromboserate hauptsächlich durch die unterschiedlichen Studiendesigns, prospektive versus retrospektive Datenerhebung, unterschiedliche Asparaginasepräparate (Erwinia, E. coli A, E. coli B), alleine oder in Kombination mit Steroiden, und die unterschiedliche Anzahl der untersuchten Patienten begründet ist.

Keywords

Childhood ALL - symptomatic thrombosis - prothrombotic risk factors - asparaginase - steroids

Schlüsselwörter

Kinder und ALL - symptomatische Thrombose - genetische Thromboserisikofaktoren - Asparaginase - Steroide

Volltext

Referenzen

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