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Thrombotic and hemorrhagic strokes complicating early therapy for childhood acute lymphoblastic leukemia
Author(s) -
Priest John R.,
Ramsay Norma K. C.,
Latchaw Richard E.,
Lockman Lawrence A.,
Hasegawa Duane K.,
Coates Thomas D.,
Coccia Peter F.,
Edson J. Roger,
Nesbit Mark E.,
Krivit William
Publication year - 1980
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19801001)46:7<1548::aid-cncr2820460709>3.0.co;2-7
Subject(s) - medicine , leukocytosis , thrombosis , chemotherapy , induction chemotherapy , antithrombin , surgery , acute lymphocytic leukemia , cerebral infarction , coagulopathy , leukemia , heparin , lymphoblastic leukemia , ischemia
Sudden cerebrovascular insults occurred during or immediately following remission induction therapy in 4 children with acute lymphoblastic leukemia. In 3, cerebral infarction was due to thrombosis. In the fourth, an intracerebral hematoma developed representing either frank hemorrhaging or a hemorrhagic infarction. None of the patients had central nervous system leukemia or extreme leukocytosis at the time of diagnosis. Symptoms were obtundation, hemiparesis, seizures, and headache. The induction chemotherapy included L‐asparaginase which causes deficiencies of antithrombin, plasminogen, fibrinogen, and factors IX and XI. These hemostatic abnormalities may explain the thromboses and bleeding observed in these children.