De Sa Hong, Deloughery Thomas, Kaempf Andy, Lachowiez Curtis, Leonard Jessica, Mathews Rick, Rakshe Shauna, Shatzel Joseph J, Swords Ronan, Traer Elie, Hayes-Lattin Brandon
Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA.
Biostatistics Shared Resource, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA.
Leuk Lymphoma. 2025 Jan;66(1):34-43. doi: 10.1080/10428194.2024.2405874. Epub 2024 Sep 18.
Thrombosis rates among young adults receiving asparaginase (ASP) for acute lymphoblastic leukemia (ALL) can reach 34%, with highest risk during induction. Our institution implemented a standard practice of 1 mg/kg/day enoxaparin administered to young adults with ALL who are treated with ASP during induction. We performed a retrospective analysis of patients who received thromboprophylaxis with enoxaparin 1 mg/kg/day during ASP-containing induction for ALL at Oregon Health & Science University from 2012 to 2023. The primary outcome was the cumulative incidence of thrombosis during induction. Bleeding events were assessed. Sixty-two patients were included in our analysis. Four patients (6.5%; 95% CI 1.8%-15.7%) experienced a thrombotic event. Three events were catheter-associated and 1 event was a distal lower extremity deep vein thrombosis related to myositis. No cerebral sinus thromboses, thrombosis-related deaths or major bleeding events occurred. Intermediate-dose enoxaparin is a promising thromboprophylaxis strategy and warrants further prospective research.
接受天冬酰胺酶（ASP）治疗急性淋巴细胞白血病（ALL）的年轻成人血栓形成率可达34%，诱导期风险最高。我们机构实施了一项标准做法，即对诱导期接受ASP治疗的ALL年轻成人给予1mg/kg/天的依诺肝素。我们对2012年至2023年在俄勒冈健康与科学大学接受含ASP诱导治疗ALL期间接受1mg/kg/天依诺肝素进行血栓预防的患者进行了回顾性分析。主要结局是诱导期血栓形成的累积发生率。评估出血事件。62例患者纳入我们的分析。4例患者（6.5%；95%CI 1.8%-15.7%）发生血栓事件。3例事件与导管相关，1例事件为与肌炎相关的远端下肢深静脉血栓形成。未发生脑窦血栓形成、血栓形成相关死亡或重大出血事件。中等剂量依诺肝素是一种有前景的血栓预防策略，值得进一步进行前瞻性研究。
