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

Research output: Contribution to journalArticle

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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Precursor Cell Lymphoblastic Leukemia-Lymphoma
Fibrinogen
Surveys and Questionnaires
Thrombosis
Therapeutics
Retrospective Studies
Observation
Hemorrhage

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

In: Journal of Pediatric Hematology/Oncology, 11.01.2019.

Research output: Contribution to journalArticle

Giordano, P, Grassi, M, Saracco, P, Luciani, M, Colombini, A, Testi, AM, Micalizzi, C, Petruzziello, F, Putti, MC, Casale, F, Consarino, C, Mura, RM, Mastrodicasa, E, Notarangelo, LD, Onofrillo, D, Pollio, B, Rizzari, C, Tafuri, S, De Leonardis, F, Corallo, PC & 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
Giordano, Paola ; Grassi, Massimo ; Saracco, Paola ; Luciani, Matteo ; Colombini, Antonella ; Testi, Anna M ; Micalizzi, Concetta ; Petruzziello, Fara ; Putti, Maria C ; Casale, Fiorina ; Consarino, Caterina ; Mura, Rosa M ; Mastrodicasa, Elena ; Notarangelo, Lucia D ; Onofrillo, Daniela ; Pollio, Berardino ; Rizzari, Carmelo ; Tafuri, Silvio ; De Leonardis, Francesco ; Corallo, Paola C ; Santoro, Nicola. / 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. In: Journal of Pediatric Hematology/Oncology. 2019.
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title = "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",
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.",
author = "Paola Giordano and Massimo Grassi and Paola Saracco and Matteo Luciani and Antonella Colombini and Testi, {Anna M} and Concetta Micalizzi and Fara Petruzziello and Putti, {Maria C} and Fiorina Casale and Caterina Consarino and Mura, {Rosa M} and Elena Mastrodicasa and Notarangelo, {Lucia D} and Daniela Onofrillo and Berardino Pollio and Carmelo Rizzari and Silvio Tafuri and {De Leonardis}, Francesco and Corallo, {Paola C} and Nicola Santoro",
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T1 - Human Fibrinogen Concentrate and Fresh Frozen Plasma in the Management of Severe Acquired Hypofibrinogenemia in Children With Acute Lymphoblastic Leukemia

T2 - Results of a Retrospective Survey

AU - Giordano, Paola

AU - Grassi, Massimo

AU - Saracco, Paola

AU - Luciani, Matteo

AU - Colombini, Antonella

AU - Testi, Anna M

AU - Micalizzi, Concetta

AU - Petruzziello, Fara

AU - Putti, Maria C

AU - Casale, Fiorina

AU - Consarino, Caterina

AU - Mura, Rosa M

AU - Mastrodicasa, Elena

AU - Notarangelo, Lucia D

AU - Onofrillo, Daniela

AU - Pollio, Berardino

AU - Rizzari, Carmelo

AU - Tafuri, Silvio

AU - De Leonardis, Francesco

AU - Corallo, Paola C

AU - Santoro, Nicola

PY - 2019/1/11

Y1 - 2019/1/11

N2 - 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.

AB - 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.

U2 - 10.1097/MPH.0000000000001390

DO - 10.1097/MPH.0000000000001390

M3 - Article

C2 - 30640822

JO - Journal of Pediatric Hematology/Oncology

JF - Journal of Pediatric Hematology/Oncology

SN - 1077-4114

ER -