학술논문
In BCR-ABL1 Positive B-Cell Acute Lymphoblastic Leukemia, Steroid Therapy Induces Hypofibrinogenemia
Document Type
article
Author
Elisa Buzzatti; Fabio Forghieri; Giovangiacinto Paterno; Francesco Marchesi; Chiara Sarlo; Fabio Giglio; Nicola Fracchiolla; Mariarita Sciumè; Raffaele Palmieri; Fabiana Esposito; Luca Guarnera; Lisa Mercante; Maria Rosaria Pascale; Flavia Mallegni; Arianna Savi; Vittorio Forte; Luca Maurillo; Francesco Buccisano; Adriano Venditti; Maria Ilaria Del Principe
Source
Journal of Clinical Medicine, Vol 11, Iss 7, p 1776 (2022)
Subject
Language
English
ISSN
2077-0383
Abstract
Hypofibrinogenemia (HF) in adult acute lymphoblastic leukemia (ALL) of B lineage is uncommon and mostly associated with asparaginase (ASP) delivery. Since we noticed a significant reduction in fibrinogen (FBG) plasma levels even before the first ASP dose, we aim to assess the levels of FBG during induction treatment and explore if the FBG fall correlated with therapies other than asparaginase and/or specific leukemia biological features. We retrospectively analyzed FBG levels in 115 patients with B-ALL. In 74 (64%) out of 115 patients FBG decline occurred during the steroid prephase. In univariate analysis, such a steroid-related HF was significantly associated with BCR-ABL1 rearrangement (p = 0.00158). None of those experiencing HF had significant modifications of liver function tests during induction treatment. Our retrospective study suggests that in B-ALL, steroid therapy can also induce HF and that such an event is preferentially observed in patients carrying BCR-ABL1 rearrangements. The pathogenesis of this phenomenon is still unclear. We attempt to explain it by applying the International Society of Thrombosis and Hemostasis-Disseminated Intravascular Coagulation score (ISTH-DIC score); nonetheless additional studies are needed to clarify further the mechanisms of HF in this subset of patients.