Beinart Garth, Damon Lloyd
Department of Hematology/Oncology, University of California-San Francisco, San Francisco, California, USA.
Am J Hematol. 2004 Dec;77(4):331-5. doi: 10.1002/ajh.20230.
L-asparaginase is a chemotherapeutic agent commonly used in the treatment of both adult and pediatric acute lymphoblastic leukemia (ALL). A major complication is thrombosis, resulting from reduced synthesis of proteins such as antithrombin III. Hypofibrinogenemia, also a side effect, may be a marker of thrombosis and decreased protein synthesis. A retrospective chart review of identically treated patients revealed 9 thrombotic events among 93 patients (10%), 6 (7%) occurring during treatment cycles including L-asparaginase. Twelve (13%) patients had fibrinogen levels <50 mg/dL. Of these, 3 (25%) suffered a thrombotic event. This results in a specificity of 90% and a relative risk of 10 (P = 0.014). Therefore, a fibrinogen <50 mg/dL may serve as a marker for a hypercoagulable state in ALL patients receiving L-asparaginase.
L-天冬酰胺酶是一种常用于治疗成人和儿童急性淋巴细胞白血病(ALL)的化疗药物。一个主要并发症是血栓形成,这是由抗凝血酶III等蛋白质合成减少导致的。低纤维蛋白原血症也是一种副作用,可能是血栓形成和蛋白质合成减少的一个标志。对接受相同治疗的患者进行的回顾性病历审查显示,93例患者中有9例发生血栓事件(10%),其中6例(7%)发生在包括L-天冬酰胺酶的治疗周期中。12例(13%)患者的纤维蛋白原水平<50mg/dL。其中,3例(25%)发生了血栓事件。这导致特异性为90%,相对风险为10(P=0.014)。因此,纤维蛋白原<50mg/dL可能作为接受L-天冬酰胺酶治疗的ALL患者高凝状态的一个标志。