Blood: Anticoagulase replaces the effect of preventing venous thrombosis

Patients receiving treatment for acute lymphoblastic leukemia (ALL) are at risk of thrombosis, in part because of the use of L-thymidamidase (L-ASP)Anticoagulase (AT) replacement has been recommended to prevent venous thrombosis (VTE), which may increase ASP exposurein this study,researchers reported the results of preventive alternative therapy in pediatric-related prospective studies (GRAALL-2005)from 2006 to 2014, there were 784 newly diagnosed All adult patients with a Bloodion chromosome (Ph) negativeThe incidence of VTE was 16%, of which 69% occurred during induction therapyThe majority of patients (87%) receive at-replacement therapyThe incidence of AT REPLACEMENT had no significant effect on the incidence of VTE (8% vs 14%) after excluding patients who had not been treated with L-ASP or had a blood clot prior to treatment with L-ASPThe application of concentrated fibrinogen was associated with an increased risk of VTE (17% vs 9%), but there was no effect on infusion of fresh frozen plasmaHeparin prevention was associated with an increased risk of VTE (13% vs7%)Preventive measures were not associated with an increased risk of complications from stage 3-4 bleedingThe recurrence rate of L-ASP after re-entry of VTE was 3% (1/34)in all patients treated with L-ASP, the use of fibrinoprogen concentrates may increase the risk of thrombosis and should be limited to patients who suffer from bleeding caused only by rare fibrinogen reductionAlthough enhanced AT replacement therapy was used as an additional precaution, patients developed venous thrombosisalthough this large-scale descriptive study does not prove the effectiveness of these preventive measures, it provides important insights to guide future experimental design