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Table 1 Potential interactions of thrombophilia and antileukemic agents

From: Evaluation for inherited and acquired prothrombotic defects predisposing to symptomatic thromboembolism in children with acute lymphoblastic leukemia: a protocol for a prospective, observational, cohort study

Thrombophilia ALL or Chemotherapeutic agent Possible interaction
PT gene polymorphism 20210A ALL PT mutation may exaggerate ALL-induced thrombin generation
Corticosteroid May induce higher levels of PT
MTHFR C677T Methotrexate By inhibiting folate pathway induces functional MTHFR deficiency even in heterozygous patients with resultant high Hcy levels
FVL Asparaginase By reducing protein C levels may exaggerate the effects of FVL even in heterozygous subjects
Protein C, S and AT deficiency Asparaginase By inhibiting protein synthesis results in reduction in Proteins C, S and AT
Elevated pro-coagulant factors VIII:C, IX and XI Corticosteroid May induce higher levels of factors VIII:C, IX and XI
Elevated Lp(a) levels Asparaginase Lead to mark elevation in Lp(a)
  1. Abbreviations: ALL acute lymphoblastic leukemia, PT prothrombin, MTHFR methylene tetrahydrofolate reductase, Hcy homocysteine, FVL Factor V Leiden, AT antithrombin, FVIII:C Coagulation factor VIII:C, Lp(a) Lipoprotein a