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Supportive care for hemostatic complications associated with pediatric leukemia: a national survey in Japan.

Abstract

Optimal supportive care for disseminated intravascular coagulation (DIC) and hemostatic complications by asparaginase is indispensable for the successful treatment of pediatric leukemia. However, the situation regarding this type of care in Japan is unclear. We conducted a questionnaire-based survey at 155 institutions treating childhood leukemia in Japan. The questionnaire asked about the supportive care provided by each institution to acute leukemia patients with DIC and asparaginase-induced hemostatic alterations. Ninety-eight institutions responded. The most common diagnostic criteria for DIC were those established by the Japanese Ministry of Health and Welfare. Regardless of the etiology underlying DIC, recombinant human thrombomodulin and synthetic protease inhibitors were used as anticoagulation therapy by around 70% and 40% of institutions, respectively. Additionally, 92%, 93%, and 73% of institutions measured plasma antithrombin, fibrinogen, and D-dimer/fibrin degradation products, respectively, more than twice per week during induction therapy for acute lymphoblastic leukemia. Survey responses indicate that 95% and 24% of the institutions used antithrombin replacement and fresh-frozen plasma, respectively. Supportive care for DIC and/or asparaginase-induced hemostatic alterations at Japanese pediatric centers was intensive and differs markedly from protocols in other countries. The efficacy of supportive care should be evaluated prospectively in the setting of pediatric leukemia.

Authors+Show Affiliations

Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. shinn-o@koto.kpu-m.ac.jp.Department of Pediatrics, Dokkyo Medical University School of Medicine, Tochigi, Japan.Department of Pediatrics, Akita University Hospital, Akita, Japan.Pediatric Hematology and Oncology Department, Okinawa Prefectural Medical Center and Children's Medical Center, Okinawa, Japan.Department of Pediatrics, Sapporo Hokuyu Hospital, Hokkaido, Japan.Department of Pediatrics, Jikei University School of Medicine, Tokyo, Japan.Department of Pediatrics, Kagoshima City Hospital, Kagoshima, Japan.Department of Pediatrics, Gifu Municipal Hospital, Gifu, Japan.Akabane Zaitaku Clinic, Tokyo, Japan.Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31559563

Citation

Osone, Shinya, et al. "Supportive Care for Hemostatic Complications Associated With Pediatric Leukemia: a National Survey in Japan." International Journal of Hematology, 2019.
Osone S, Fukushima K, Yano M, et al. Supportive care for hemostatic complications associated with pediatric leukemia: a national survey in Japan. Int J Hematol. 2019.
Osone, S., Fukushima, K., Yano, M., Kakazu, M., Sano, H., Kato, Y., ... Adachi, S. (2019). Supportive care for hemostatic complications associated with pediatric leukemia: a national survey in Japan. International Journal of Hematology, doi:10.1007/s12185-019-02740-9.
Osone S, et al. Supportive Care for Hemostatic Complications Associated With Pediatric Leukemia: a National Survey in Japan. Int J Hematol. 2019 Sep 26; PubMed PMID: 31559563.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Supportive care for hemostatic complications associated with pediatric leukemia: a national survey in Japan. AU - Osone,Shinya, AU - Fukushima,Keitaro, AU - Yano,Michihiro, AU - Kakazu,Mariko, AU - Sano,Hirozumi, AU - Kato,Yoko, AU - Shinkoda,Yuichi, AU - Shinoda,Kunihiro, AU - Mori,Naoko, AU - Adachi,Souichi, Y1 - 2019/09/26/ PY - 2019/07/09/received PY - 2019/09/18/accepted PY - 2019/09/17/revised PY - 2019/9/28/entrez KW - Asparaginase-induced thrombosis KW - Children KW - Disseminated intravascular coagulation KW - Leukemia KW - Supportive care JF - International journal of hematology JO - Int. J. Hematol. N2 - Optimal supportive care for disseminated intravascular coagulation (DIC) and hemostatic complications by asparaginase is indispensable for the successful treatment of pediatric leukemia. However, the situation regarding this type of care in Japan is unclear. We conducted a questionnaire-based survey at 155 institutions treating childhood leukemia in Japan. The questionnaire asked about the supportive care provided by each institution to acute leukemia patients with DIC and asparaginase-induced hemostatic alterations. Ninety-eight institutions responded. The most common diagnostic criteria for DIC were those established by the Japanese Ministry of Health and Welfare. Regardless of the etiology underlying DIC, recombinant human thrombomodulin and synthetic protease inhibitors were used as anticoagulation therapy by around 70% and 40% of institutions, respectively. Additionally, 92%, 93%, and 73% of institutions measured plasma antithrombin, fibrinogen, and D-dimer/fibrin degradation products, respectively, more than twice per week during induction therapy for acute lymphoblastic leukemia. Survey responses indicate that 95% and 24% of the institutions used antithrombin replacement and fresh-frozen plasma, respectively. Supportive care for DIC and/or asparaginase-induced hemostatic alterations at Japanese pediatric centers was intensive and differs markedly from protocols in other countries. The efficacy of supportive care should be evaluated prospectively in the setting of pediatric leukemia. SN - 1865-3774 UR - https://www.unboundmedicine.com/medline/citation/31559563/Supportive_care_for_hemostatic_complications_associated_with_pediatric_leukemia:_a_national_survey_in_Japan L2 - https://dx.doi.org/10.1007/s12185-019-02740-9 DB - PRIME DP - Unbound Medicine ER -