Effect of L-asparaginase on the coagulation function in patients with acute lymphoblastic leukemia / 中国现代医生

ABSTRACT

Objective To investigate the effect of L-asparaginase on the coagulation function of patients with acute lymphoblastic leukemia. Methods The general information of 100 patients with acute lymphoblastic leukemia from January 2013 to January 2017 admitted in the Department of Hematolog was retrospectively analyzed. All patients received no anticoagulation before chemotherapy. All patients were treated with routine treatment after admission, namely with vincristine + daunorubicin + prednisone induction therapy and then with VDLP regimen chemotherapy, combined with intravenous injection of L-asparaginase 8000 U/m2, once every other day. After 3 months of treatment, its clinical efficacy was evaluated, and adverse reactions during treatment were observed. The changes of coagulation indexes were compared before treatment and at 1 day and 7 days after treatment. Results Of the 100 patients, there were 22 cases of complete remission, 40 cases of partial remission, 26 cases of stable condition and 12 cases of progression, with total efficiency of 62％(62/100). During the treatment of 100 patients, 10 cases had allergy, 9 had a drop in white blood cell count, and 8 had gastrointestinal reactions including nausea and vomiting. On the first day after treatment, the levels of PT, APTT and TT in 100 patients were significantly higher than those before treatment, with significant difference (P＜ 0. 05 or P＜0. 01). However, the FIB level in patients was significantly lower than that before treatment, with significant difference (P＜0. 05). There were no significant differences between the levels of PT, APTT and TT in all patients at one week after treatment and those before treatment (P＞0. 05). Although FIB level in all patients at one week after treatment increased compared with that at one day after treatment, the difference had no significant difference. While the level of FIB was significantly lower than that before treatment, and the difference was significant (P＜0. 05). Conclusion L-asparaginase is effective and safe in the treatment of acute lymphoblastic leukemia, but it is easy to produce adverse reactions such as abnormal coagulation function. Therefore, the clinical application of L-asparaginase in the treatment of acute lymphoblastic leukemia should be dynamically monitored in patients in order to actively correct coagulation disorders, and the drug should be discontinued when necessary.