Özet:

L-Asparaginase is an important drug for the treatment of childhood acute lymphoblastic leukemia (ALL). The impairment of protein synthesis due to the depletion of asparagine by asparaginase leads to decreases in albumin and deterioration in hemostasis tests.  The objectives of the present study were to conduct a retrospective evaluation of levels of fibrinogen, total protein/albumin during induction chemotherapy in children with ALL treating according to the BFM 2009 protocol.For this purpose, the laboratory data of 45 pediatric ALL patients in the induction chemotherapy between August 2011 and March 2016 were retrospectively evaluated. This study was approved by the institutional review board of Eskişehir Osmangazi University Faculty of Medicine (Ethics approval No: 80558721/105). The median fibrinogen level on day 12 was already reduced by 62% compared to the before treatment values, but this difference was not statistically significant (p>0.05).  After 15 days of therapy, the level of fibrinogen decreased to 27%, total protein decreased to 89%, albumin decreased to 92% of the inital value (p<0.001,p<0.01,p<0.05, respectively). The lowest fibrinogen and total protein/albumin levels were observed on the 21st and 27th days of chemotherapy. Thrombotic complication developed in three children (9.3%). The results showed that the levels of fibrinogen and total protein/albumin were significantly reduced during the induction chemotherapy. Keywords: induction chemotherapy, L-asparaginase, children, fibrinogen, protein, albumin. Keywords: induction chemotherapy, L-asparaginase, children, fibrinogen, protein, albumin Source: Asparaginase is an important drug used in the treatment of acute lymphoblastic leucemia in childhood.The disruption in the protein synthesis caused by asparaginase due to the extinction of asparaginase causes a decrease in the albumin and a disruption in the hemostasis tests. The aim of this study is to retrospective assess the fibrinogenic, total protein/albumin levels during inductive chemotherapy in acute lymphoblastic leukemic children treated in accordance with the BFM 2009 protocol. For this purpose, the laboratory parameters of 45 patients who received induction chemotherapy between August 2011 and March 2016 were reverse examinations. The study was approved by the Council of Ethics for Clinical Research at Eskişehir Osmangazi University (Ethics Board approval number: 80558721/105). In the eighteenth day, the median fibrinogenic levels decreased by 62% compared to the beginning of treatment. However, this difference was not statistically meaningful (p>0.05). In the 15th day after treatment, the median fibrinogen levels fell to 27% of the pre-treatment value, to 89% of the total protein, to 92% of the albumin (p<0,001,p<0,01,p<0,05, respectively). Fibrinogenic and total protein/albumin levels were at low levels in the 21st and 27th days.  Three patients developed tromboembolic complications (9.3%). The results of the study showed that during inductive chemotherapy, the total blood protein/albumin levels were significantly decreased. Keywords: induction chemotherapy, L-Asparaginase, child, fibrinogenic, protein, albumin

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