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Current Oncology
Volume 23
Issue 4
10.3747/co.23.3077
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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
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Article

Venous Thromboembolism Prevention During Asparaginase-Based Therapy for Acute Lymphoblastic Leukemia

by
H. Sibai
1,
J.T. Seki
2,3,*,
T.Q. Wang
2,3,
N. Sakurai
4,
E.G. Atenafu
5,
K.W.L. Yee
1,
A.C. Schuh
1,
V. Gupta
1,
M.D. Minden
1,
A.D. Schimmer
1 and
J.M. Brandwein
6
1
Department of Medical Oncology and Hematology, University Health Network, Toronto, ON, Canada
2
Department of Pharmacy, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
3
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
4
Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
5
Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
6
Division of Hematology, University of Alberta, Edmonton, AB, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2016, 23(4), 355-361; https://doi.org/10.3747/co.23.3077
Submission received: 5 May 2016 / Revised: 6 June 2016 / Accepted: 8 July 2016 / Published: 1 August 2016

Abstract

Background: Venous thromboembolism (vte) is a recognized complication in patients treated with asparaginase-containing chemotherapy regimens; the optimal preventive strategy is unclear. We assessed the safety and efficacy of prophylaxis using low-dose low molecular weight heparin in adult patients with acute lymphoblastic leukemia in complete remission treated with an asparaginase-based post-remission chemotherapy regimen. Methods: As part of the intensification phase of the Dana-Farber Cancer Institute 91-01 regimen, asparaginase was administered weekly to 41 consecutive patients for 21–30 weeks; these patients also received prophylaxis with enoxaparin 40 mg daily (60 mg for patients ≥ 80 kg). Outcomes were assessed against outcomes in a comparable cohort of 99 patients who received the same chemotherapy regimen without anticoagulation prophylaxis. Results: The overall rate of symptomatic venous thrombosis was not significantly different in the prophylaxis and non-prophylaxis cohorts (18.92% and 21.74% respectively). Among patients receiving prophylaxis, vte occurred in higher proportion in those who weighed at least 80 kg (42.86% vs. 4.35%, p = 0.0070). No major bleeding complications occurred in the prophylaxis group (minor bleeding: 8.1%). Conclusions: Prophylaxis with low-dose enoxaparin during the intensification phase was safe, but was not associated with a lower overall proportion of vte.
Keywords: anticoagulants; asparaginase; leukemia; venous thromboembolism; prophylaxis anticoagulants; asparaginase; leukemia; venous thromboembolism; prophylaxis

Share and Cite

MDPI and ACS Style

Sibai, H.; Seki, J.T.; Wang, T.Q.; Sakurai, N.; Atenafu, E.G.; Yee, K.W.L.; Schuh, A.C.; Gupta, V.; Minden, M.D.; Schimmer, A.D.; et al. Venous Thromboembolism Prevention During Asparaginase-Based Therapy for Acute Lymphoblastic Leukemia. Curr. Oncol. 2016, 23, 355-361. https://doi.org/10.3747/co.23.3077

AMA Style

Sibai H, Seki JT, Wang TQ, Sakurai N, Atenafu EG, Yee KWL, Schuh AC, Gupta V, Minden MD, Schimmer AD, et al. Venous Thromboembolism Prevention During Asparaginase-Based Therapy for Acute Lymphoblastic Leukemia. Current Oncology. 2016; 23(4):355-361. https://doi.org/10.3747/co.23.3077

Chicago/Turabian Style

Sibai, H., J.T. Seki, T.Q. Wang, N. Sakurai, E.G. Atenafu, K.W.L. Yee, A.C. Schuh, V. Gupta, M.D. Minden, A.D. Schimmer, and et al. 2016. "Venous Thromboembolism Prevention During Asparaginase-Based Therapy for Acute Lymphoblastic Leukemia" Current Oncology 23, no. 4: 355-361. https://doi.org/10.3747/co.23.3077

APA Style

Sibai, H., Seki, J. T., Wang, T. Q., Sakurai, N., Atenafu, E. G., Yee, K. W. L., Schuh, A. C., Gupta, V., Minden, M. D., Schimmer, A. D., & Brandwein, J. M. (2016). Venous Thromboembolism Prevention During Asparaginase-Based Therapy for Acute Lymphoblastic Leukemia. Current Oncology, 23(4), 355-361. https://doi.org/10.3747/co.23.3077

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