Evaluation of coagulopathy before and during induction chemotherapy for acute lymphoblastic leukaemia, including assessment of global clotting tests

摘要

Patients with acute lymphoblastic leukaemia (ALL) are at high venous thromboembolism (VTE) risk (affecting between 1.5 and 37% 1 , 2 ) with up to 50% affecting the cerebral veins. 3 , 4 , 5 , 6 Thrombosis is a potentially avoidable source of morbidity and mortality in ALL patients, particularly during the early phases of chemotherapy. 7 , 8 Prevention and treatment of thrombosis with antithrombotic drugs may be complicated by co-existent bleeding risk due to factors such as thrombocytopenia and the need for procedures. Conventional clotting tests (platelet count (PLT), prothrombin time (PT), partial thromboplastin time (PTT), Clauss fibrinogen) only measure isolated components of haemostasis with no measure of cellular/plasma interactions, platelet function, natural anticoagulants, Von Willebrand factor (VWF) and fibrinolysis.