Safety and feasibility of lower antithrombin replacement targets in adult patients with hematological malignancies receiving asparaginase therapy
| Autor: | Michelle A. Elliott, Candy S. Peskey, Naseema Gangat, Mrinal M. Patnaik, Kristen B. McCullough, Aref Al-Kali, William J. Hogan, Ross A. Dierkhising, Kristin C. Mara, Jason N. Barreto, Mark R. Litzow, Dennis A. Gastineau, Louis Letendre |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Asparaginase medicine.medical_treatment Cost-Benefit Analysis Kaplan-Meier Estimate Gastroenterology Article Antithrombins 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine Outcome Assessment Health Care medicine Humans Proportional Hazards Models Retrospective Studies Chemotherapy Adult patients business.industry Incidence (epidemiology) Antithrombin Induction chemotherapy Retrospective cohort study Thrombosis Hematology Middle Aged medicine.disease Surgery Oncology chemistry 030220 oncology & carcinogenesis Hematologic Neoplasms Feasibility Studies Female business 030215 immunology medicine.drug |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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