Coagulopathic side effect of L-asparaginase on fibrinogen level in childhood acute lymphoblastic leukemia during induction phase

Alqasim, Alauldeen Mudhafar Zubair; Al-Hadithi, Raji; Al-Khalidi, Aseel Nashaat

doi:10.1016/j.hemonc.2018.01.003

Cited by 7 publications

(6 citation statements)

References 8 publications

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“…In one of the previous studies, a decrease in serum albumin and increases in ALT and fatty liver were observed in hepatic imaging of patients after LA utilization 8,9 . In addition, LA was shown to reduce fibrinogen's hepatic synthesis, which illustrates its coagulopathic adverse effects 10 …”

Section: Introductionmentioning

confidence: 77%

“…8,9 In addition, LA was shown to reduce fibrinogen's hepatic synthesis, which illustrates its coagulopathic adverse effects. 10 Developing natural drugs from medicinal plants to hepatic function stimulation, enabling organ protection or hepatic cells regeneration in liver injuries, might be more effective alternative treatments with low toxicity than chemical medications. 11,12 However, the existence of biological barriers in the body, consisting of drug-metabolizing enzymes and efflux transporters, could negatively affect the efficiency and pharmacokinetic characteristics of the plant and prevent them from reaching their intended sites of action.…”

mentioning

confidence: 99%

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Hepatoprotective effect of nanoniosome loaded Myristica fragrans phenolic compounds in mice‐induced hepatotoxicity

Poorbagher

Karimi

Oskoueian

2022

J Cellular Molecular Medi

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The liver is the most significant organ for the detoxification of toxic substances in the human body. As a biological barrier, it can remove different exogenous substances through phagocytosis. 1 Druginduced liver injury is an extended term that refers to any hepatic injury which results from a prescribed medication. 2 LA is an antineoplastic agent, which is utilized as a therapy for acute lymphoblastic leukaemia (ALL). Asparagine is an essential amino acid for leukaemia cells' growth, but they lack asparagine synthase and rely upon the host's asparagine supply for protein production. LA act as an anti-ALL by catalysing Asparagine degradation into aspartate and ammonia and decreasing the glutamine pool. 3 Amino acid reduction results in depletion in protein synthesis, causing mitochondrial dysfunction, metabolic stress and ROS generation in leukaemia cells, mediating their death. However, this reduced protein synthesis leads to impaired mitochondria β-oxidation and unoxidized fatty acid accumulation in the hepatic parenchyma. This can lead to hepatocyte necrosis, which is not very notable, though steatosis is usually seen in 50%-90% of occasions. 4 Mild elevation of transaminases and

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Section: Introductionmentioning

confidence: 77%

mentioning

confidence: 99%

Hepatoprotective effect of nanoniosome loaded Myristica fragrans phenolic compounds in mice‐induced hepatotoxicity

Poorbagher

Karimi

Oskoueian

2022

J Cellular Molecular Medi

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“…Moreover, studies on patients with acute lymphatic leukemia on asparaginase treatment showed depletion of fibrinogen. 20,21…”

Section: Asns Impact On Hepatic Functionmentioning

confidence: 99%

Asparagine Synthetase Deficiency with Intracranial Hemorrhage Can Mimic Molybdenum Cofactor Deficiency

Abdel-Salam

Abdel‐Hamid

2020

Neuropediatrics

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Here we report a consanguineous Egyptian family with two siblings presented with congenital microcephaly, early-onset epileptic encephalopathy, feeding difficulties, and early lethality. The condition was initially diagnosed as molybdenum cofactor deficiency as the brain imaging for one of them showed brain edema and intracranial hemorrhage in addition to the hypoplastic corpus callosum, vermis hypoplasia, and small-sized pons. Subsequently, whole exome sequencing identified a novel homozygous missense variant in exon 4 of ASNS gene c.397_398GT > CA (p.Val133Gln) confirming the diagnosis of asparagine synthetase deficiency syndrome. No discernible alternative cause for the intracranial hemorrhage was found. Our patient is the second to show asparagine synthetase deficiency and intracranial hemorrhage, thus confirming the involvement of ASNS gene. As such, it is important to consider asparagine synthetase deficiency syndrome in patients with microcephaly, brain edema, and neonatal intracranial hemorrhage.

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“…ALL treatment per se is a known risk factor for thrombosis, especially asparaginase and corticosteroids 4,5 . Asparaginase affects several haemostatic proteins, leading to coagulopathies such as low antithrombin and hypofibrinogenaemia 6,7 . Thromboprophylaxis in ALL patients has been discussed over the years.…”

Section: Introductionmentioning

confidence: 99%

A survey on thromboprophylaxis and coagulation assessment in children and young adults with acute lymphoblastic leukaemia (ALL) in the Nordic and Baltic countries: Different practices of assessment and management

et al. 2022

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Patients undergoing treatment for acute lymphoblastic leukaemia (ALL) are at risk of coagulopathy, especially thromboembolism. We conducted a survey on practices in the assessment and management of coagulopathy during the new ALLTogether protocol in 29 (17 paediatric, 12 adult) Nordic and Baltic cancer centres. While 92% of adult centres used thromboprophylaxis with low-molecular-weight heparin, no paediatric centre did. Almost all providers performed baseline coagulation studies,

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Coagulopathic side effect of L-asparaginase on fibrinogen level in childhood acute lymphoblastic leukemia during induction phase

Abstract: Significant reduction in fibrinogen level occurred in childhood ALL patients after treatment with L-asparaginase.

Cited by 7 publications

References 8 publications

Hepatoprotective effect of nanoniosome loaded Myristica fragrans phenolic compounds in mice‐induced hepatotoxicity

Hepatoprotective effect of nanoniosome loaded Myristica fragrans phenolic compounds in mice‐induced hepatotoxicity

Asparagine Synthetase Deficiency with Intracranial Hemorrhage Can Mimic Molybdenum Cofactor Deficiency

A survey on thromboprophylaxis and coagulation assessment in children and young adults with acute lymphoblastic leukaemia (ALL) in the Nordic and Baltic countries: Different practices of assessment and management

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