Thromboembolic complications are well known in the treatment of childhood acute lymphoblastic leukemia. Over the years it has not been possible to reach a consensus on a possible prophylaxis of thromboembolic events during intensive therapy. Only the administration of enoxaparin was able to achieve evidence in the literature to date. In this retrospective study, 173 childhood leukemia patients were treated over 20 years with a thromboembolic prophylaxis including enoxaparin and AT III during induction therapy with L-asparaginase and cortisone. We here report the effectiveness of administration of enoxaparin and AT III in childhood leukemia, showing a strikingly low prevalence of deep vein thrombosis (2.9%). Especially in adolescent patients, a particularly great need for AT III was demonstrated. We recommend thromboembolic prophylaxis with enoxaparin and AT III substitution during induction/reinduction therapy with L-asparaginase and glucocorticosteroids, especially from adolescence onwards.

中文翻译：

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依诺肝素和抗凝血酶 III 预防儿童白血病药物性凝血改变：20 年回顾性经验

在儿童急性淋巴细胞白血病的治疗中，血栓栓塞并发症是众所周知的。多年来，对于强化治疗期间血栓栓塞事件的可能预防尚未达成共识。迄今为止，只有服用依诺肝素才能获得文献中的证据。在这项回顾性研究中，173 名儿童白血病患者在 L-天冬酰胺酶和可的松诱导治疗期间接受了包括依诺肝素和 AT III 在内的血栓栓塞预防治疗超过 20 年。我们在这里报告了依诺肝素和 AT III 治疗儿童白血病的有效性，显示深静脉血栓形成的患病率极低 (2.9%)。特别是在青少年患者中，对 AT III 的需求特别大。我们建议在 L-天冬酰胺酶和糖皮质激素诱导/再诱导治疗期间，特别是从青春期开始，使用依诺肝素和 AT III 替代品预防血栓栓塞。