2016
DOI: 10.1111/bjh.14048
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Incidence and risk factors for Central Nervous System thrombosis in paediatric acute lymphoblastic leukaemia during intensive asparaginase treatment: a single‐centre cohort study

Abstract: Central Nervous System (CNS) thrombosis is a complication of acute lymphoblastic leukaemia (ALL) treatment that is potentially associated with significant morbidity and neurological sequelae. Its presumably multifactorial aetiology is poorly characterized. We conducted a single-centre, retrospective cohort study on 346 ALL paediatric patients (1-16 years old) treated with asparaginase intensive Dana Farber Cancer Institute (DFCI) protocols from 1998 to 2011. The incidence, risk factors and outcome of CNS throm… Show more

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Cited by 18 publications
(18 citation statements)
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“…We performed a detailed analysis of the occurrence and risk factors for VTs in a consecutive series of adult patients diagnosed in Finland in 2000–2012 and treated according to a national study protocol ALL2000. The incidence rates of VTs were comparable to previous reports . Risk factors for truncal or CVL VTs were as hypothesized and reflected many of the traditional hazards for thrombosis detected in the general population.…”
Section: Discussionsupporting
confidence: 84%
See 1 more Smart Citation
“…We performed a detailed analysis of the occurrence and risk factors for VTs in a consecutive series of adult patients diagnosed in Finland in 2000–2012 and treated according to a national study protocol ALL2000. The incidence rates of VTs were comparable to previous reports . Risk factors for truncal or CVL VTs were as hypothesized and reflected many of the traditional hazards for thrombosis detected in the general population.…”
Section: Discussionsupporting
confidence: 84%
“…Aside from the aimed antileukemic properties, asparaginase exposes patients to multiple adverse effects such as VTs. Other suspected, although not unanimously identified, risk factors of VTs in ALL patients include high BMI, T‐cell ALL (T‐ALL), and the concomitant use of steroids . As to our knowledge, reports on whether the risk factors for CVTs and truncal or central venous line (VCL) VTs in ALL patients are alike, still lack.…”
Section: Introductionmentioning
confidence: 99%
“…Asparaginase (ASNase) was introduced as major component of ALL treatment protocols in 1970 and has been a mainstay of therapy ever since. [ 1 3 , 5 ] It is an enzyme that catalyzes the hydrolysis of the amino acid asparagine (ASN) into aspartic acid and ammonia and is thus required by all cells. Cancerous lymphoblasts usually depend on extracellular sources of asparagine to support their fast growth as they have ASNS levels that are relatively lower than their needs.…”
Section: Introductionmentioning
confidence: 99%
“…Thrombosis, defined as venous and/or arterial thromboembolism, has a higher incidence in paediatric oncology patients and is reported with both E. coli - and Erwinia -derived asparaginase (mainly due to interference with the hepatic synthesis of coagulation proteins) and has an overall incidence of around 5% according to recent studies. [ 4 , 5 ] Many factors have been associated with the risk of thrombosis, some related to the disease, others to the treatment (like the dose and duration of asparaginase exposure) as well as to patient specific factors such as older age, female gender, non-O blood group, obesity, inherited prothrombotic states or central venous catheter. [ 3 , 5 , 9 , 10 ]…”
Section: Introductionmentioning
confidence: 99%
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