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获得性抗凝血酶(AT)缺乏多为左旋门冬酰胺酶(L-Asp)治疗儿童急性淋巴细胞白血病(ALL)的严重副反应,可导致血栓栓塞,一般报道其发生率为1～15％。血栓形成之前患儿血浆AT水平减低,凝血酶生成和D-D二聚体形成增加,纤溶酶原激活抑制物(PAI-1)水平增高,处于高凝状态。为评估AT浓缩物(ATC)对L-Asp诱发凝血异常的预防价值,作者于27例ALL患儿中进行了非随机前瞻性研究。诱导采取ALL-BFM-90方案(由强的松、长春新碱、柔红霉素和L-Asp组成),L-Asp用法为10000U/m~2,于d12、15、18、21、24、27、30、33静滴。该组患儿均无出血或血栓形成的家
Acquired antithrombin (AT) deficiency is mostly due to severe side effects of L-Asp in the treatment of acute lymphoblastic leukemia (ALL) in children and can lead to thromboembolism. The incidence is generally reported as 1-15 %. Plasma thrombosis in children before AT levels decreased, thrombin generation and D-D dimer formation increased, plasminogen activator inhibitor (PAI-1) levels increased in hypercoagulable state. To assess the prophylactic value of AT concentrates (ATC) on L-Asp-induced coagulation abnormalities, the authors conducted a nonrandomized prospective study of 27 ALL children. The ALL-BFM-90 regimen (consisting of prednisone, vincristine, daunorubicin and L-Asp) was used to induce the L-Asp usage of 10000 U / m ~ 2 at d12, 15, 18, 21, 24 , 27,30,33 intravenous infusion. This group of children without bleeding or thrombosis home