Human Fibrinogen Concentrate and Fresh Frozen Plasma in the Management of Severe Acquired Hypofibrinogenemia in Children With Acute Lymphoblastic Leukemia: Results of a Retrospective Survey

Paola Giordano, Massimo Grassi, Paola Saracco, Matteo Luciani, Antonella Colombini, Anna M Testi, Concetta Micalizzi, Fara Petruzziello, Maria C Putti, Fiorina Casale, Caterina Consarino, Rosa M Mura, Elena Mastrodicasa, Lucia D Notarangelo, Daniela Onofrillo, Berardino Pollio, Carmelo Rizzari, Silvio Tafuri, Francesco De Leonardis, Paola C CoralloNicola Santoro

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Abstract

OBJECTIVE OF THE STUDY: In this study we aimed to retrospectively evaluate how centers, belonging to the Associazione Italiana Ematologia e Oncologia Pediatrica (AIEOP), manage severe acquired hypofibrinogenemia in children with acute lymphoblastic leukemia, particularly evaluating the therapeutic role of human fibrinogen concentrate (HFC) and fresh frozen plasma (FFP).

METHODS: We conducted a survey among AIEOP centers; thereafter, we collected and analyzed data with regard to the treatment of episodes of severe acquired hypofibrinogenemia occurring during the induction and reinduction phases of the AIEOP-BFM ALL 2009 protocol.

RESULTS: In total, 15 of the 37 AIEOP centers invited to join the survey agreed to collect the data, with 10 and 5 centers declaring to react to severe acquired hypofibrinogenemia (<70 mg/dL) by administering HFC or FFP, respectively. Of the 150 episodes of severe hypofibrinogenemia occurring in 101 patients, 47.3% were treated with HFC and 52.7% with FFP, with a normalization of fibrinogen levels achieved in greater proportion and in a shorter amount of time in the HFC group as compared with the FFP group. None of the patients presented with bleeding or thrombosis during the observation period.

CONCLUSIONS: Even with the limitations of the retrospective nature of this study, HFC seems to be a safe and effective alternative to FFP for replacement therapy in case of severe hypofibrinogenemia in children with acute lymphoblastic leukemia.

Original languageEnglish
Number of pages5
JournalJournal of Pediatric Hematology/Oncology
DOIs
Publication statusE-pub ahead of print - Jan 11 2019

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Giordano, P., Grassi, M., Saracco, P., Luciani, M., Colombini, A., Testi, A. M., Micalizzi, C., Petruzziello, F., Putti, M. C., Casale, F., Consarino, C., Mura, R. M., Mastrodicasa, E., Notarangelo, L. D., Onofrillo, D., Pollio, B., Rizzari, C., Tafuri, S., De Leonardis, F., ... Santoro, N. (2019). Human Fibrinogen Concentrate and Fresh Frozen Plasma in the Management of Severe Acquired Hypofibrinogenemia in Children With Acute Lymphoblastic Leukemia: Results of a Retrospective Survey. Journal of Pediatric Hematology/Oncology. https://doi.org/10.1097/MPH.0000000000001390