medigraphic.com
Medicina Universitaria

2007, Número 36

<< Anterior Siguiente >>

Med Univer 2007; 9 (36)


Actividad de las proteínas anticoagulantes C, S y antitrombina al diagnóstico de leucemia linfoblástica aguda

Pérez JCJ, Vázquez GE, Gómez AD

Idioma: Español
Referencias bibliográficas: 21
Paginas: 101-104
Archivo PDF: 99.63 Kb.


RESUMEN

Antecedentes: los niños con leucemia linfoblástica aguda tienen un riesgo elevado de complicaciones trombóticas asociadas a la disminución de actividad de las proteínas C, S y antitrombina que se ha relacionado con el tratamiento, particularmente con la administración de L-asparaginasa y la colocación de una catéter venoso central.
Objetivo: investigar si la actividad de estas proteínas disminuye al diagnóstico, antes de aplicar quimioterapia y de colocar una línea central.
Métodos: se midió la actividad de las proteínas C, S y AT al momento del diagnóstico de leucemia linfoblástica aguda; en 83 niños se dio seguimiento clínico documentando episodios tromboembólicos durante la fase de tratamiento de inducción a la remisión con un régimen de mediana intensidad en la administración de L-asparaginasa.
Resultados: la actividad de las proteínas anticoagulantes al diagnóstico de leucemia linfoblástica aguda estuvo dentro del rango normal, aunque existió una heterogeneidad considerable, probablemente debida a una tasa de síntesis hepática alterada. Esta variación en la actividad no se relacionó con el desarrollo de trombosis.
Conclusión: no se encontró disminución significativa en la actividad funcional de las proteínas C, S y AT ni episodios trombóticos en los pacientes con un nuevo diagnóstico de leucemia linfoblástica aguda.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Chabner BA, Wilson W, Supko J. Pharmacology and toxicity of antineoplastic drugs. In: Lichtman MA, Beutler E, Kipps TJ, Seligsohn U, Kaushansky K, Prchal JT, editors. Williams Hematology. 7th ed. New York: McGrawHill, 2006;pp:249-74.

  2. Faderl S, Thall PF, Kantarjian HM, Estrov Z. Time to platelet recovery predicts outcome of patients with de novo acute lymphoblastic leukaemia who have achieved a complete remission. Br J Haematol 2002;117:869-74.

  3. Nowak-Gottl U, Wermes C, Junker R, Koch HG, et al. Prospective evaluation of the thrombotic risk in children with acute lymphoblastic leukemia carrying the MTHFR TT 667 genotype, the prothrombin G20210A variant, and further prothrombotic risk factors. Blood 1999;93:1595-9.

  4. Mitchell LG, Sutor AH, Andrew M. Hemostasis in childhood acute lymphoblastic leukemia: coagulopathy induced by disease or treatment. Semin Thromb Hemost 1995;21:390-401.

  5. Ruud E, Holmstrom H, De Lange C, Natvig S, et al. Thrombotic effects of asparaginase in two acute lymphoblastic leukemia protocols (NOPHO ALL-1992 versus NOPHO ALL-2000): a single-institution study. Pediatr Hematol Oncol 2006;3:207-16.

  6. Duval M, Suciu S, Ferster A, Rialland X, et al. Comparison of Escherichia coli-asparaginase with Erwinia-asparaginase in the treatment of childhood lymphoid malignancies: results of a randomized European Organization for Research and Treatment of Cancer-Children’s Leukemia Group phase 3 trial. Blood 2002;99:2734-9.

  7. Nowak-Gottl U, Heinecke A, Von Kries R, Nurnberger W, et al. Thrombotic events revisited in children with acute lymphoblastic leukemia: impact of concomitant Escherichia coli asparaginase/prednisone administration. Thromb Res 2001;103:165-72.

  8. Athale UH, Chan AK. Thromoboembolic complications inpediatric hematologic malignancies. Semin Thromb Hemost 2007;33:416-26.

  9. Nowak-Gottl U, Ahlke E, Fleischhack G, Schwabe D, et al. Thromboembolic events in children with acute lymphoblastic leukemia (BFM protocols): prednisone versus dexamethasone administration. Blood 2003;101:2529-33.

  10. Athale UH, Siciliano SA, Crowther M, Barr RD, Chan AK. Thromboembolism in children with acute lymphoblastic leukaemia treated on Dana-Farber Cancer Institute protocols: effect of age and risk stratification of disease. Br J Haematol 2005;129:803-10.

  11. Athale UH, Chan AK. Thrombosis in children with acute lymphoblastic leukemia. Part II. Pathogenesis of thrombosis in children with acute lymphoblastic leukemia: effects of the disease and therapy. Thromb Res 2003;111:199-212.

  12. Mitchell LG, Andrew M, Hanna K, Abshire T, et al. Prophylactic Antithrombin Replacement in Kids with Acute Lymphoblastic Leukemia Treated with Asparaginase Group (PARKAA). A prospective cohort study determining the prevalence of thrombotic events in children with acute lymphoblastic leukemia and a central venous line who are treated with L-asparaginase: results of the Prophylactic Antithrombin Replacement in Kids with Acute Lymphoblastic Leukemia Treated with Asparaginase (PARKAA) Study. Cancer 2003;97:508-16.

  13. Athale UH, Chan AK. Thrombosis in children with acute lymphoblastic leukemia: part I. Epidemiology of thrombosis in children with acute lymphoblastic leukemia. Thromb Res 2003;111:125-31.

  14. Hill FG, Richards S, Gibson B, Hann I, et al. Successful treatment without cranial radiotherapy of children receiving intensified chemotherapy for acute lymphoblastic leukaemia: results of the risk-stratified randomized central nervous system treatment trial MRC UKALL XI (ISRC TN 16757172).The UK Medical Research Council Working Party on Childhood Leukaemia. Br J Haematol 2004;124:33-46.

  15. Laffan MA, Manning RA. Investigation of a thromobotic tendency. In: Lewis SM, Bain BJ, Bates I, editors. Dacie and Lewis practical haematology, 9th ed. London: Churchill Livingstone 2001;pp:391-413.

  16. Guglielmone HA, Vides MA. A novel functional assay of protein C in human plasma and its comparison with amidolytic and anticoagulant assays. Thromb Haemost 1992;67:46-49.

  17. Laroche P, Plassart V, Amiral J. Rapid quantitative latex immunoassays for diagnosis of thrombotic disorders. Thromb Haemost 1989;62:379-82.

  18. Ruiz-Arguelles A, Rivadeneyra-Espinoza L, Duque RE, Orfao A (on behalf of the participants of the Latin American Consensus Conference). Report on the Second Latin American consensus conference for flow cytometric immunophenotyping of hematological malignancies. Cytometry B Clin Cytom 2006;70:39-44.

  19. Moghrabi A, Levy DE, Asselin B, Barr R, et al. Results of the Dana-Farber Cancer Institute ALL Consortium Protocol 95-01 for children with acute lymphoblastic leukemia. Blood 2007;109:896-904.

  20. Oner AF, Gurgey A, Kirazli S, Okur H, Tunc B. Changes of hemostatic factors in children with acute lymphoblastic leukemia receiving combined chemotherapy including high dose methylprednisolone and L-asparaginase. Leuk Lymphoma 1999;33:361-4.

  21. Jaime Perez JC, Gomez Almaguer D. The complex nature of the prothrombotic state in acute lymphoblastic leukemia of childhood. Haematologica 2003;88:ELT25.




2020     |     www.medigraphic.com