Anticoagulation prophylaxis reduces venous thromboembolism rate in adult acute lymphoblastic leukaemia treated with asparaginase-based therapy.

Adolescent Adult Aged Anticoagulants / administration & dosage Asparaginase / administration & dosage Female Humans Male Middle Aged Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy Retrospective Studies Venous Thromboembolism / chemically induced
acute lymphoblastic leukemia anticoagulation thrombosis

Journal

British journal of haematology
ISSN: 1365-2141
Titre abrégé: Br J Haematol
Pays: England
ID NLM: 0372544

Informations de publication

Date de publication:
12 2020
Historique:
received: 24 02 2020
accepted: 07 04 2020
pubmed: 13 5 2020
medline: 24 3 2021
entrez: 13 5 2020
Statut: ppublish

Résumé

Venous thromboembolism (VTE) is a well-known complication in adults receiving asparaginase (ASNase)-based intensification chemotherapy for acute lymphoblastic leukaemia (ALL). The optimal preventative strategy is unclear. Our objective is to determine the effects of low-molecular-weight heparin (LMWH) as primary VTE prophylaxis. A single-centred retrospective cohort study of adult patients with Philadelphia chromosome negative (Ph-) ALL who received ASNase-based intensification from 2001 to 2017, with prophylaxis given from 2011 to 2017. In all, 214 patients were included in this study with 99 in the historical control group and 125 in the prophylaxis group. The mean (range) enoxaparin dose was 0·79 (0·39-1·2) mg/kg. Of the 125 patients in the prophylaxis group 17 (13·6%) developed VTE during the intensification phase, while 27/99 patients (27·3%) in the control cohort experienced at least one thrombotic event (odds ratio [OR] 0·42, 95% confidence interval [CI] 0·21-0·83). Overall, the main sites of VTE incidences included deep vein thrombosis in the lower extremity (54·6%), pulmonary embolism (13·6%) and catheter-related thrombosis (22·7%). In addition, we found that after adjusting for age, T-phenotype ALL was associated with VTE development (OR 3·07, 95% CI 1·04-9·08). There was no documented major bleeding in the prophylaxis group. LMWH prophylaxis reduced the incidence of symptomatic VTE in adult patients with ALL receiving intensification chemotherapy with ASNase.

Identifiants

DOI: 10.1111/bjh.16695 PMID: 32395867
pubmed: 32395867
doi: 10.1111/bjh.16695
doi:

Substances chimiques

Anticoagulants 0
Asparaginase EC 3.5.1.1

Types de publication

Clinical Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

748-754

Informations de copyright

© 2020 British Society for Haematology and John Wiley & Sons Ltd.

Références

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Auteurs

Hassan Sibai (H)

Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Department of Medicine, University of Toronto, Toronto, ON, Canada.

Ruiqi Chen (R)

Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Department of Medicine, University of Toronto, Toronto, ON, Canada.
ORCID: 0000-0002-1008-4194

Xing Liu (X)

Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.

Umberto Falcone (U)

Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Department of Medicine, University of Toronto, Toronto, ON, Canada.

Aaron Schimmer (A)

Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Department of Medicine, University of Toronto, Toronto, ON, Canada.

Andre Schuh (A)

Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Department of Medicine, University of Toronto, Toronto, ON, Canada.

Arjun Law (A)

Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Department of Medicine, University of Toronto, Toronto, ON, Canada.
ORCID: 0000-0002-9251-3609

Caroline McNamara (C)

Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Department of Medicine, University of Toronto, Toronto, ON, Canada.

Dawn Maze (D)

Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Department of Medicine, University of Toronto, Toronto, ON, Canada.

Karen Yee (K)

Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Department of Medicine, University of Toronto, Toronto, ON, Canada.

Mark Minden (M)

Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Department of Medicine, University of Toronto, Toronto, ON, Canada.

Steven M Chan (SM)

Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Department of Medicine, University of Toronto, Toronto, ON, Canada.

Vikas Gupta (V)

Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Department of Medicine, University of Toronto, Toronto, ON, Canada.

Tracy Murphy (T)

Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Department of Medicine, University of Toronto, Toronto, ON, Canada.

Naoko Sakurai (N)

Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.

Eshetu G Atenafu (EG)

Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.

Joseph M Brandwein (JM)

Division of Hematology, University of Alberta, Edmonton, AB, Canada.

Jack T Seki (JT)

Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
Department of Pharmacy, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adolescent › Anticoagulation prophylaxis reduces venous...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Anticoagulation prophylaxis reduces venous...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Anticoagulation prophylaxis reduces venous...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Utilisations thérapeutiques › Agents hématologiques › Anticoagulants › Anticoagulation prophylaxis reduces venous...
questionsmedicales.fr › Enzymes et coenzymes › Enzymes › Hydrolases › Amidohydrolases › Asparaginase › Anticoagulation prophylaxis reduces venous...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Anticoagulation prophylaxis reduces venous...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Anticoagulation prophylaxis reduces venous...
questionsmedicales.fr › Maladies du système immunitaire › Syndromes immunoprolifératifs › Syndromes lymphoprolifératifs › Leucémie lymphoïde › Leucémie-lymphome lymphoblastique à précurseurs B et T › Anticoagulation prophylaxis reduces venous...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Anticoagulation prophylaxis reduces venous...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Embolie et thrombose › Thromboembolie › Thromboembolisme veineux › Anticoagulation prophylaxis reduces venous...