Corso A, Castagnola C, Bernasconi C
Institute of Hematology, Policlinico San Matteo, Pavia, Italy.
Ann Hematol. 1997 Sep;75(3):117-9. doi: 10.1007/s002770050324.
It is well established that in acute lymphoblastic leukemia (ALL) patients L-asparaginase (L-Ase) provokes thrombotic events reducing coagulation inhibitors in both adults and children. A tight correlation between thrombotic and hemorrhagic complications and ALL has also been hypothesized because of the high incidence of disseminated intravascular coagulation (DIC) found during the early period of chemotherapeutic treatment apart from L-Ase. All the authors reporting on this subject, however, consider the remission induction phase of treatment the most risky, if not exclusive, for the development of a thrombotic event, in particular if it includes the administration of L-Ase. We report here two cases of ALL patients who experienced a cerebral sinus thrombosis in a later phase of treatment, demonstrating that the thrombotic risk is surely exacerbated by chemotherapy but is not exclusive to the remission induction period.
众所周知，在急性淋巴细胞白血病（ALL）患者中，L-天冬酰胺酶（L-Ase）会引发血栓形成事件，从而降低成人和儿童体内的凝血抑制剂水平。由于在化疗早期除L-Ase外还发现弥散性血管内凝血（DIC）的高发生率，因此也有人推测血栓形成和出血并发症与ALL之间存在密切关联。然而，所有报道这一主题的作者都认为，治疗的缓解诱导期即使不是唯一的，也是血栓形成事件发生风险最高的阶段，尤其是在使用L-Ase的情况下。我们在此报告两例ALL患者，他们在治疗后期发生了脑静脉窦血栓形成，这表明化疗肯定会加剧血栓形成风险，但并非仅限于缓解诱导期。
