Correlation between asparaginase enzyme activity levels and coagulation parameters during childhood acute lymphoblastic leukemia treatment

Pediatr Blood Cancer. 2023 Feb;70(2):e30085. doi: 10.1002/pbc.30085. Epub 2022 Nov 15.

Abstract

Thromboembolism is a serious toxicity in the treatment of acute lymphoblastic leukemia (ALL), but little is known about the correlation between asparaginase enzyme activity (ASA) levels and coagulation parameters. We included 65 non-high risk ALL patients, aged 1-17 years. Coagulation parameters and corresponding ASA levels were measured during asparaginase treatment. We found ASA to be negatively correlated with antithrombin and fibrinogen up to ASA levels of 250 IU/L, after which these parameters reached a plateau and did not decrease further with further increase of ASA. Patients with silent inactivation of asparaginase had normal coagulation parameters.

Keywords: PEG-asparaginase; antithrombin; pediatric acute lymphoblastic leukemia; thromboembolism; toxicities.

MeSH terms

  • Adolescent
  • Antineoplastic Agents* / adverse effects
  • Antithrombins / pharmacology
  • Asparaginase* / analysis
  • Blood Coagulation
  • Child
  • Child, Preschool
  • Fibrinogen
  • Humans
  • Infant
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma* / drug therapy

Substances

  • Antineoplastic Agents
  • Antithrombins
  • Asparaginase
  • Fibrinogen