PB1669 RISK FACTORS FOR THROMBOEMBOLISM IN ADULT PATIENTS WITH ACUTE LYMPHOBLASTIC LEUKEMIA

Abstract

Background:Thromboembolism frequently complicates treatment of acute lymphoblastic leukemia (ALL).Aims:A single‐center retrospective study was conducted with the objective of assessing the risk factors for thromboembolism in adult patients with ALL.Methods:The study included 87 consecutive patients (aged 19–70 years; 57 males) treated for ALL; B‐cell (n = 40), T‐cell (n = 26), Ph+ (n = 13), byphenotypic (n = 3) and unclassified (n = 5) during the 10‐year period. All patients but one received intensive treatment, including L‐asparginase in 57 (65%) patients, while 23 (26%) underwent allogenic stem cell transplantation. Vast majority of patients (n = 80, 92%) had central venous catheters at least once during the treatment period, including peripherally inserted central catheter (PICC) placed in 18 (21%) patients.Results:Fourteen patients (16%) developed thrombosis during the study period. Deep venous thrombosis was described in 9(65%), pulmonary embolism in 2(14%), and cerebral sinus thrombosis in 3(21%) patients. One death was attributable to thromboembolism. The risk of thromboembolism was associated with the induction treatment, protocols including L‐asparginase, the use of central venous catheters, namely PICC, and non‐0 blood groups.Summary/Conclusion:Our results demonstrate high incidence of thromboembolic events in patients with ALL. The highest risk is attributed with the use of L‐asparginase, despite vigorous control of coagulation parameters and antithrombin substitution. Finally, our results strongly suggest against simultaneous use of L‐asparginase and PICC.