Coagulopathic side effect of L-asparaginase on fibrinogen level in childhood acute lymphoblastic leukemia during induction phase |
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Institution: | 1. Department of Pathology, College of Medicine, University of Mustansiriyah, Baghdad, Iraq;2. Scientific Council of Pathology of the Iraqi Board, Baghdad, Iraq;3. Department of Hematology, Teaching Laboratories, Medical City, Baghdad, Iraq |
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Abstract: | BackgroundL-asparaginase is chemotherapeutic agent commonly used in treatment of Acute Lymphoblastic Leukemia. Thromboembolic and to a lesser extent bleeding events are serious complications associated with administration of this drug during the induction phase in ALL especially in children resulting from reduced synthesis of proteins such as Antithrombin & fibrinogen.ObjectiveEvaluation of the coagulopathic side effect of L-asparaginase during the induction phase in treatment of ALL in children by measuring fibrinogen levels before & after administration of this drug.Subjects & methodAn interventional prospective study was performed on 30 newly diagnosed children with ALL, all of them received 9 cycles of L-asparaginase during the induction phase according to UKALL 2003 Protocol.Fibrinogen was measured before & after treatment with L-asparaginase and the results are compared to a control group of 30 healthy children age & sex matched.ResultsReduced fibrinogen level is observed in 13 out of 30 patients (43.3%) after treatment with L-asparaginase ranging from 25 to 110 mg/dl with means fibrinogen before & after treatment of 252 ± 16.40 mg/dl & 158.97 ± 17.88 mg/dl respectively (p < .0001).ConclusionSignificant reduction in fibrinogen level occurred in childhood ALL patients after treatment with L-asparaginase. |
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Keywords: | L-asparaginase Fibrinogen Childhood ALL Induction Coagulopathy Chemotherapy |
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