Safety and feasibility of lower antithrombin replacement targets in adult patients with hematological malignancies receiving asparaginase therapy*

Jason N. Barreto, Kristen B. McCullough, Candy S. Peskey, Ross A. Dierkhising, Kristin C. Mara, Michelle A. Elliott, Dennis A. Gastineau, Aref Al-Kali, Naseema Gangat, Louis Letendre, William Hogan, Mark R Litzow, Mrinal M Patnaik

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

The optimal antithrombin(AT) activity parameters for replacement as thromboprophylaxis following asparaginase remains unclear. This single-center, retrospective study evaluated two sets of AT replacement thresholds and targets in adults receiving asparaginase-containing chemotherapy. AT supplementation adhered to institutional standards, which lowered the AT activity target from 100% to 80% in 6/2014. Ninety-two patients were evaluated. Cumulative thrombosis incidence was 16% at 6 months (95%CI:6.8–24.0, maximum follow-up 315 days) with similar incidence between the 80% and 100% target groups, 14% (2 of the 14) and 13% (10 of the 78), respectively, with a small non-Line-Related DVT incidence (3%). Most thrombotic events occurred during induction chemotherapy and demonstrated no associations with replacement target, cumulative days or cumulative area under AT activity target, number of asparaginase doses, or cumulative asparaginase dose. Median estimated AT replacement expenditure was $34,963USD (IQR $16,260USD to $79,319USD) per patient. Cost-effectiveness and optimization of AT replacement for thromboprophylaxis following asparaginase requires prospective evaluation.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalLeukemia and Lymphoma
DOIs
StateAccepted/In press - Apr 13 2017

Keywords

  • Antithrombin
  • asparaginase
  • hematological malignancy
  • thromboprophylaxis
  • thrombosis

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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    Barreto, J. N., McCullough, K. B., Peskey, C. S., Dierkhising, R. A., Mara, K. C., Elliott, M. A., Gastineau, D. A., Al-Kali, A., Gangat, N., Letendre, L., Hogan, W., Litzow, M. R., & Patnaik, M. M. (Accepted/In press). Safety and feasibility of lower antithrombin replacement targets in adult patients with hematological malignancies receiving asparaginase therapy* Leukemia and Lymphoma, 1-10. https://doi.org/10.1080/10428194.2017.1312384