L-asparaginase and venous thromboembolism in acute lymphocytic leukemia

Gaurav Goyal, Vijaya R Bhatt

Research output: Contribution to journalReview article

14 Citations (Scopus)

Abstract

The occurrence of venous thromboembolism (VTE) in acute lymphocytic leukemia patients receiving L-asparaginase therapy may cause significant morbidity, neurological sequela and possibly worse outcomes. The prophylactic use of antithrombin infusion (to keep antithrombin activity >60%) or low molecular weight heparin (LMWH) may reduce the risk of VTE. The decision to continue L-asparaginase therapy after the development of VTE should be based on anticipated benefits, severity of VTE and the ability to continue therapeutic anticoagulation. In patients receiving asparaginase rechallenge, the use of therapeutic LMWH, monitoring of anti-Xa level and antithrombin level are important. Novel oral anticoagulants are not dependent on antithrombin level, hence offer theoretical advantages over LMWH for the prevention and therapy of asparaginase-related VTE.

Original languageEnglish (US)
Pages (from-to)2459-2470
Number of pages12
JournalFuture Oncology
Volume11
Issue number17
DOIs
StatePublished - Sep 1 2015

Fingerprint

Asparaginase
Venous Thromboembolism
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Antithrombins
Low Molecular Weight Heparin
Therapeutic Uses
Therapeutics
Anticoagulants
Morbidity

Keywords

  • acute lymphocytic leukemia
  • asparaginase
  • thrombosis
  • venous thromboembolism

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Medicine(all)

Cite this

L-asparaginase and venous thromboembolism in acute lymphocytic leukemia. / Goyal, Gaurav; Bhatt, Vijaya R.

In: Future Oncology, Vol. 11, No. 17, 01.09.2015, p. 2459-2470.

Research output: Contribution to journalReview article

@article{492e96cd21b44bb5bf6a1505055f20f4,
title = "L-asparaginase and venous thromboembolism in acute lymphocytic leukemia",
abstract = "The occurrence of venous thromboembolism (VTE) in acute lymphocytic leukemia patients receiving L-asparaginase therapy may cause significant morbidity, neurological sequela and possibly worse outcomes. The prophylactic use of antithrombin infusion (to keep antithrombin activity >60{\%}) or low molecular weight heparin (LMWH) may reduce the risk of VTE. The decision to continue L-asparaginase therapy after the development of VTE should be based on anticipated benefits, severity of VTE and the ability to continue therapeutic anticoagulation. In patients receiving asparaginase rechallenge, the use of therapeutic LMWH, monitoring of anti-Xa level and antithrombin level are important. Novel oral anticoagulants are not dependent on antithrombin level, hence offer theoretical advantages over LMWH for the prevention and therapy of asparaginase-related VTE.",
keywords = "acute lymphocytic leukemia, asparaginase, thrombosis, venous thromboembolism",
author = "Gaurav Goyal and Bhatt, {Vijaya R}",
year = "2015",
month = "9",
day = "1",
doi = "10.2217/fon.15.114",
language = "English (US)",
volume = "11",
pages = "2459--2470",
journal = "Future Oncology",
issn = "1479-6694",
publisher = "Future Medicine Ltd.",
number = "17",

}

TY - JOUR

T1 - L-asparaginase and venous thromboembolism in acute lymphocytic leukemia

AU - Goyal, Gaurav

AU - Bhatt, Vijaya R

PY - 2015/9/1

Y1 - 2015/9/1

N2 - The occurrence of venous thromboembolism (VTE) in acute lymphocytic leukemia patients receiving L-asparaginase therapy may cause significant morbidity, neurological sequela and possibly worse outcomes. The prophylactic use of antithrombin infusion (to keep antithrombin activity >60%) or low molecular weight heparin (LMWH) may reduce the risk of VTE. The decision to continue L-asparaginase therapy after the development of VTE should be based on anticipated benefits, severity of VTE and the ability to continue therapeutic anticoagulation. In patients receiving asparaginase rechallenge, the use of therapeutic LMWH, monitoring of anti-Xa level and antithrombin level are important. Novel oral anticoagulants are not dependent on antithrombin level, hence offer theoretical advantages over LMWH for the prevention and therapy of asparaginase-related VTE.

AB - The occurrence of venous thromboembolism (VTE) in acute lymphocytic leukemia patients receiving L-asparaginase therapy may cause significant morbidity, neurological sequela and possibly worse outcomes. The prophylactic use of antithrombin infusion (to keep antithrombin activity >60%) or low molecular weight heparin (LMWH) may reduce the risk of VTE. The decision to continue L-asparaginase therapy after the development of VTE should be based on anticipated benefits, severity of VTE and the ability to continue therapeutic anticoagulation. In patients receiving asparaginase rechallenge, the use of therapeutic LMWH, monitoring of anti-Xa level and antithrombin level are important. Novel oral anticoagulants are not dependent on antithrombin level, hence offer theoretical advantages over LMWH for the prevention and therapy of asparaginase-related VTE.

KW - acute lymphocytic leukemia

KW - asparaginase

KW - thrombosis

KW - venous thromboembolism

UR - http://www.scopus.com/inward/record.url?scp=84942246469&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84942246469&partnerID=8YFLogxK

U2 - 10.2217/fon.15.114

DO - 10.2217/fon.15.114

M3 - Review article

VL - 11

SP - 2459

EP - 2470

JO - Future Oncology

JF - Future Oncology

SN - 1479-6694

IS - 17

ER -