Ex Vivo Thrombin Generation Assessment of Four Anticoagulants in Children with Acute Lymphoblastic Leukemia.

What was studied

Venous clots (VTE) are a serious problem in children with ALL. ALL is acute lymphoblastic leukemia. There is no consensus on anticoagulant treatment or prevention in these children. Direct oral anticoagulants (DOACs) have not been well studied here. DOACs were recently approved for VTE in children. This study tested anticoagulant drugs in 67 children with ALL. It compared them with healthy controls. It used a thrombin generation assay. Samples were taken before and after asparaginase therapy. Drugs were added to the samples in the lab.

What they found

Low-molecular-weight heparin kept its activity before and after asparaginase. Thrombin peak height fell by 29 and 31. This was similar to healthy controls. The factor Xa inhibitors apixaban and rivaroxaban had little effect. Thrombin peak height fell by 7 to 13. In controls it fell by 48 to 59. Dabigatran, an oral thrombin inhibitor, had strong activity before and after asparaginase. Lag time was prolonged by 180 and 134. This was like controls.

What it means for patients

The authors say these lab findings back the activity of LMWH and dabigatran as anticoagulants. They say the clinical efficacy of dabigatran in children with ALL needs further study. They say this should be confirmed in prospective in vivo studies.

Why it is not certain yet

These were ex vivo lab tests, not treatment in patients. The authors say dabigatran needs confirmation in prospective in vivo studies. The abstract gives no clinical outcomes. A single study can only show so much.

Source

Ex Vivo Thrombin Generation Assessment of Four Anticoagulants in Children with Acute Lymphoblastic Leukemia.

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