{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T22:52:05Z","timestamp":1793141525934,"version":"4.5.0"},"reference-count":41,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T00:00:00Z","timestamp":1647993600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Hypofibrinogenemia (HF) in adult acute lymphoblastic leukemia (ALL) of B lineage is uncommon and mostly associated with asparaginase (ASP) delivery. Since we noticed a significant reduction in fibrinogen (FBG) plasma levels even before the first ASP dose, we aim to assess the levels of FBG during induction treatment and explore if the FBG fall correlated with therapies other than asparaginase and\/or specific leukemia biological features. We retrospectively analyzed FBG levels in 115 patients with B-ALL. In 74 (64%) out of 115 patients FBG decline occurred during the steroid prephase. In univariate analysis, such a steroid-related HF was significantly associated with BCR-ABL1 rearrangement (p = 0.00158). None of those experiencing HF had significant modifications of liver function tests during induction treatment. Our retrospective study suggests that in B-ALL, steroid therapy can also induce HF and that such an event is preferentially observed in patients carrying BCR-ABL1 rearrangements. The pathogenesis of this phenomenon is still unclear. We attempt to explain it by applying the International Society of Thrombosis and Hemostasis-Disseminated Intravascular Coagulation score (ISTH-DIC score); nonetheless additional studies are needed to clarify further the mechanisms of HF in this subset of patients.<\/jats:p>","DOI":"10.3390\/jcm11071776","type":"journal-article","created":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T22:08:06Z","timestamp":1648073286000},"page":"1776","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["In BCR-ABL1 Positive B-Cell Acute Lymphoblastic Leukemia, Steroid Therapy Induces Hypofibrinogenemia"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3478-5083","authenticated-orcid":false,"given":"Elisa","family":"Buzzatti","sequence":"first","affiliation":[{"name":"Hematology, Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy"},{"name":"U.O.S.D. Mieloproliferative, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Forghieri","sequence":"additional","affiliation":[{"name":"Section of Hematology, Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, AOU Policlinico, 41124 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8944-0795","authenticated-orcid":false,"given":"Giovangiacinto","family":"Paterno","sequence":"additional","affiliation":[{"name":"Hematology, Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy"},{"name":"U.O.S.D. Mieloproliferative, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Marchesi","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Sarlo","sequence":"additional","affiliation":[{"name":"Hematology, University Campus Biomedico, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4755-9533","authenticated-orcid":false,"given":"Fabio","family":"Giglio","sequence":"additional","affiliation":[{"name":"Hematology and Bone Marrow Transplantation Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Fracchiolla","sequence":"additional","affiliation":[{"name":"UOC Ematologia, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariarita","family":"Scium\u00e8","sequence":"additional","affiliation":[{"name":"UOC Ematologia, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2855-8121","authenticated-orcid":false,"given":"Raffaele","family":"Palmieri","sequence":"additional","affiliation":[{"name":"Hematology, Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy"},{"name":"U.O.S.D. Mieloproliferative, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana","family":"Esposito","sequence":"additional","affiliation":[{"name":"Hematology, Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy"},{"name":"U.O.S.D. Mieloproliferative, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8293-0663","authenticated-orcid":false,"given":"Luca","family":"Guarnera","sequence":"additional","affiliation":[{"name":"Hematology, Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy"},{"name":"U.O.S.D. Mieloproliferative, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Mercante","sequence":"additional","affiliation":[{"name":"Hematology, Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy"},{"name":"U.O.S.D. Mieloproliferative, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Rosaria","family":"Pascale","sequence":"additional","affiliation":[{"name":"Hematology, Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy"},{"name":"U.O.S.D. Mieloproliferative, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Mallegni","sequence":"additional","affiliation":[{"name":"Hematology, Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy"},{"name":"U.O.S.D. Mieloproliferative, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Savi","sequence":"additional","affiliation":[{"name":"Hematology, Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy"},{"name":"U.O.S.D. Mieloproliferative, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Forte","sequence":"additional","affiliation":[{"name":"U.O.S.D. Mieloproliferative, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Maurillo","sequence":"additional","affiliation":[{"name":"U.O.S.D. 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