Miniero R, Saracco P, Einaudi S, Garofalo F, Lange M M, Madon E
Department of Paediatrics, University of Turin, Italy.
Drugs Exp Clin Res. 1987;13(6):377-9.
Haemostatic changes induced with vincristine (VCR), prednisone (PDN) and L-asparaginase (L-ase) in 53 children with ALL were prospectively evaluated. Relative to pretreatment values, mean FG concentration diminished significantly in the first week with a minimal level in the third week and PT was prolonged during the first weeks of induction. APTT decreased significantly in the last week and after cessation of L-ase therapy. Mean concentration of factor VIII remained elevated during the entire period of L-ase therapy. Three children (5.6%) developed a cerebral thrombo/haemorrhagic complication. These data demonstrate that the tendency for thrombosis is the predominant clinical manifestation of L-ase-induced coagulopathy, when the drug is associated with VCR and PDN.
对53例急性淋巴细胞白血病患儿使用长春新碱（VCR）、泼尼松（PDN）和L-天冬酰胺酶（L-ase）诱导止血变化进行了前瞻性评估。与治疗前值相比，纤维蛋白原（FG）平均浓度在第一周显著降低，第三周降至最低水平，诱导治疗的前几周凝血酶原时间（PT）延长。活化部分凝血活酶时间（APTT）在最后一周及L-ase治疗停止后显著降低。在L-ase治疗的整个期间，因子VIII平均浓度持续升高。3例患儿（5.6%）发生了脑栓塞/出血并发症。这些数据表明，当L-ase与VCR和PDN联用时，血栓形成倾向是L-ase诱导的凝血病的主要临床表现。
