Abstract Number: PB1291
Meeting: ISTH 2020 Congress
Background: The children with Acute Lymphoblastic Leukemia(ALL) have the high risk of thrombosis(around 36%) while asymptomatic thrombosis presents in nearly 70% of ALL patients. The use of CVCs and chemotherapy can affect the development of thrombosis. The assessment of the hemostasis in children with ALL is still important and actual problem.
Aims: To evaluate the state of hemostasis system in children with ALL to identify the high-risk group.
Methods: Seventy three patients(45 boys, 28 girls, 1-17yr, median 5yr) with ALL were enrolled in this study. The patients were treated using ALL-MB-2015 protocol. APTT, TT, PR, fibrinogen, ATIII, D-dimer levels, Thromboelastography(TEG), Thrombodynamics(TD), thrombomodulin(TM) and endothelin-1(ET-1) levels were used to assess coagulation state in patients before and during the treatment.
Results: TEG parameters and clotting tests were normal(nearly 66%) or in hypocoagulation(nearly 34%) area during the treatment. Fibrinogen and ATIII lowered during the treatment in 72% and 41% of patients respectively. Thrombosis occurred in 40 patients(55%). TD revealed hypercoagulation in 80%. We’ve divided patients in two groups: 1st with low ATIII level and 2nd with normal ATIII level. There was 53% of thrombosis in 1st group if patients had hypercoagulation by TD and normal D-dimer levels, but only 16% if they had normal TD or high D-dimer levels. Even there was 45% of thrombosis in 2nd group with normal ATIII also if patients had hypercoagulation by TD and low D-dimer levels. There was no thrombosis in both groups with TD in normal area. Interesingly, we see threefold increase of TM and ET-1 levels in patients with thrombosis(p< 0.001) compared to patients without thrombosis.
Conclusions: The endothelium dysfunction confirmed by high TM and ET-1 levels and the reduced lysis potential confirmed by low ATIII, normal D-dimer levels and hypercoagulation by TD is the hypothetic group of parameters to predict thrombotic complication in children with ALL.
To cite this abstract in AMA style:Seregina E, Zharikova L, Trubina N, Korsantiya M, Gracheva M, Vuimo T, Poletaev A, Ataullakhanov F. Thrombosis and Laboratory Monitoring in Children with Acute Lymphoblastic Leukemia [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/thrombosis-and-laboratory-monitoring-in-children-with-acute-lymphoblastic-leukemia/. Accessed September 29, 2023.
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