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. 2019 May;41(4):275-279.
doi: 10.1097/MPH.0000000000001390.

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  1 , Massimo Grassi  2 , Paola Saracco  3 , Matteo Luciani  4 , Antonella Colombini  5 , Anna M Testi  6 , Concetta Micalizzi  7 , Fara Petruzziello  8 , Maria C Putti  9 , Fiorina Casale  10 , Caterina Consarino  11 , Rosa M Mura  12 , Elena Mastrodicasa  13 , Lucia D Notarangelo  14 , Daniela Onofrillo  15 , Berardino Pollio  3 , Carmelo Rizzari  5 , Silvio Tafuri  16 , Francesco De Leonardis  2 , Paola C Corallo  1 , Nicola Santoro  2
Affiliations

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 et al. J Pediatr Hematol Oncol. 2019 May.

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.

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