Thrombotic Complications During Induction Chemo
therapy of Acute Childhood Lymphoblastic Leukemia
SUTHIDA KANKIRAW ATANA, M.D., M.Sc. *, GA VIV ANN VEERAKUL, M.D.*,
KLEEBSABAI SANPAKIT, M.D.*, VORA V ARN S. TANPHAICHITR, M.D., M.S.*,
PATRAPORN AKKABUTR, M.D.*, LERLUGSN SUWA NTOL, B.Sc. *,
CHULARAT ANA MAHASANDANA, M.D.*
Affiliation : * Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
AbstractThe incidence of thrombosis during induction chemotherapy of acute childhood lympho
blastic leukemia (ALL) patients was 6 found to be in 105 (5.7%). There were 4 cerebral infarctions,
1 superior vena cava (SVC) obstruction and 1 deep vein thrombosis. Among these, 2 of them
died. A prospective study was further conducted of the change in coagulation and anticoagulation
factors during 6 weeks of induction chemotherapy. It was found that the activated partial thrombo
plastin time (aPTf) was within normal range in all cases throughout 6 weeks, while prothrombin
time (PT) and thrombin time (TI) were slightly prolonged, especially during the first 3 weeks of this
phase. The natural anticoagulant panels which included protein C (PC), protein S (PS) and anti
thrombin III (AT III) and also fibrinogen level, were lower during the first 3 weeks and reached its
nadir during the second and third week. The lower level of natural anticoagulants might be an impor
tant predisposing factor for the occurrence of thrombosis in these patients.
Keywords : Thrombosis, Induction Chemotherapy, Acute Childhood Lymphoblastic Leukemia
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