Abstract
Clotting abnormalities can occur with L-Asp therapy. During routine monitoring of coagulation studies in 7 consecutive patients with acute lymphocvtic leukemia receiving L-Asp IV (1000 μ/Kg/da × 10 d) a prolonged PTT was noted in all. In order to determine the frequency of specific clotting abnormalities, 5 of these patients were studied more thoroughly. The PT was normal in all. The thrombin time was prolonged in 3/5 subjects. The fibrinogen level was abnormal in 4/5, but never fell to less than 100 mg%. Fibrin split products were not detected in any subject. Factors XII, XI, X, VII and V remained normal while F-VIII demonstrated occasional inconsistent abnormalities. In all patients, depressed levels of F-IX occurred with the minimum levels ranging from 11 to 19%. No F-IX inhibitors were found. The low F-IX levels remained low until the drug was discontinued, then promptly returned to normal in 4-7 days. In several patients, the drug was continued in spite of the clotting defect and clinical bleeding manifestations did not occur. Liver function tests were normal in all. The coagulation abnormalities were observed with 3 different lots of L-Asp. These findings indicate a pattern of coagulation abnormalities not previously noted: specifically that the most frequently occurring disturbance is depression of F-IX levels which was observed uniformly in all subjects studied prospectively.
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Sills, R., Nelson, D., Stockman, J. et al. L-ASPARAGINASE (L-ASP) INDUCED COAGULATION ABNORMALITIES. Pediatr Res 11, 480 (1977). https://doi.org/10.1203/00006450-197704000-00664
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DOI: https://doi.org/10.1203/00006450-197704000-00664
