Abstract
Two children with acute lymphoblastic leukemia that were complicated by CNS hemorrhage or peripheral thrombosis associated with chemotherapy of multiple drugs including L-asparaginase (L-Asp) were reported. Case 1 is a 13-year-old boy with common ALL. He was treated with dexamethasone, VCR, THP-ADR and L-Asp. On the day following four times of L-Asp injection, he developed generalized tonic and chronic seizure. At that time CT scan of the head revealed a left parietal intracranial hemorrhage. He was given fresh frozen plasma and antithrqmbin III concentrates. His outcome was good and he could receive subsequent therapy without further complications. Case 2 is a 9-year-old girl with common ALL. She was treated with prednisolone, VCR, THP-ADR and L-Asp. On the day following nine times of L-Asp injection, her left leg became painfully swollen. Peripheral venous thrombosis was diagnosed. We studied changes of blood coagulation factors and fibrinolytic proteins during the therapy of Tokyo Children Cancer Study Group 12th and 13th protocols. Plasma level of factors VII, IX, X, XI, XII and AT III was decreased and also fibrinogen concentration became low during the therapy with L-Asp. We also noticed that plasma level of blood coagula-tion factors was decreased even though during the chemotherapy without L-Asp.
