Abstract Number: PB1104
Meeting: ISTH 2021 Congress
Background: Venous thromboembolism (VTE) is one serious complication in patients with acute lymphoblastic leukemia (ALL) with an incidence of 1-14% in thromboembolic symptomatic patients and up to 37% in the asymptomatic. In these patients, VTE is a multifactorial event: leukemia, central venous catheter (CVC), chemotherapy, in particular, asparaginase (ASP), and steroids. ASP is an effective chemotherapeutic agent that catalyzes the hydrolysis of asparagine. Treatment with ASP increases the risk for VTE. Among the causes that can determine an increased thromboembolic risk, the presence of congenital or acquired thrombophilia can play a crucial role.
Aims: The aim of our study was to evaluate the role of thrombophilia on VTE events in pediatric patients (age < 18 years) and in adolescents and young adults (AYA) < 40 years old with ALL during ASP chemotherapy regimens.
Methods: We defined ASP-associated thrombosis when the event occurred within 1 month from the drug administration. All patients performed the inherited and acquired thrombophilia assays at disease diagnosis before chemotherapy start.
We studied 96 ALL patients and their characteristics are summarized in table 1. Thrombotic complications occurred in 15/96 (15.6%) patients. Overall, 6/15 (40%) patients with the thrombotic complication presented thrombophilia (p = 0.265). Of the 15 thrombotic events, 7/15 (47%) were associated with the use of ASP. Notably, 5/7 presented thrombophilia (p=0.008). In the multivariate analysis, among the predictive factors for ASP-related thrombosis considered (sex, age, thrombophilia, and T-ALL), the only significant factor for thrombotic events development was thrombophilia (p = 0.0029, IC 0.025-0.823; HR 0.143).
Conclusions: Although thrombophilia is a well-known risk factor for VTE in ALL, our study focused on its link with ASP-related VTE. We suggests that screening for thrombophilia should be performed in ALL patients before ASP administration, since thrombophilic ALL patients may benefit from VTE prophylaxis.
To cite this abstract in AMA style:Serrao A, Assanto GM, Santoro C, Bianchi S, Olivieri S, Canichella M, Testi AM, Chistolini A. The Role of Thrombophilia in Asparaginase Related Venous Thromboembolism in Pediatric and Young Adult Patients Affected by Acute Lymphoblastic Leukemia [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/the-role-of-thrombophilia-in-asparaginase-related-venous-thromboembolism-in-pediatric-and-young-adult-patients-affected-by-acute-lymphoblastic-leukemia/. Accessed December 6, 2023.
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