Qiaolei Zhang1, Xueying Li2, Zhangyue Wei2, Xiujin Ye3, Lixia Zhu2, Mixue Xie2, Wanzhuo Xie2, Jingjing Zhu2, Li Li2, Yanlong Zheng2, Xiudi Yang2, Mingyu Zhu2, Jianai Sun2. 1. Department of Hematology, The First Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, Zhejiang Province, China; Department of Hematology, Lishui People's Hospital, Lishui, Zhejiang Province, China. 2. Department of Hematology, The First Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, Zhejiang Province, China. 3. Department of Hematology, The First Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, Zhejiang Province, China. Electronic address: yxjsunny@zju.edu.cn.
Abstract
BACKGROUND: Although high mortality in patients with acute leukemia (AL) is associated with intracranial hemorrhage (ICH), the clinical features and pathogenesis of AL patients with cerebral hemorrhage are not well known. METHODS: We diagnosed 90 patients with ICH from a total of 1467 patients with non-promyelocytic AL who had been hospitalized in the First Affiliated Hospital of Medical School of Zhejiang University from January 2010 to October 2015. Moreover, the risk factors of ICH death were evaluated. RESULT: Median age at ICH was 51years old, in which men accounted for 52.2%. They also accounted for 85.6% of acute myeloid leukemia. The relative incidence of ICH was the highest in M2 and M5 (60.1%). ICH presented with higher peripheral blood white blood cell count (WBC) (P<0.001), lower peripheral platelet counts (P<0.001), lower albumin (P<0.001), lower fibrous protein (P<0.001) and prolongation of prothrombin time (P<0.001) compared to those observed in the patients of NICH group; multivariate analysis, independent risk factors for death in patients with ICH include: WBC≥30.00×109/l and prothrombin time≥12.91 s. CONCLUSIONS: Leukocytosis and coagulation dysfunctions might be the main pathogenesis of acute leukemia complicated with cerebral hemorrhage.
BACKGROUND: Although high mortality in patients with acute leukemia (AL) is associated with intracranial hemorrhage (ICH), the clinical features and pathogenesis of ALpatients with cerebral hemorrhage are not well known. METHODS: We diagnosed 90 patients with ICH from a total of 1467 patients with non-promyelocytic AL who had been hospitalized in the First Affiliated Hospital of Medical School of Zhejiang University from January 2010 to October 2015. Moreover, the risk factors of ICH death were evaluated. RESULT: Median age at ICH was 51years old, in which men accounted for 52.2%. They also accounted for 85.6% of acute myeloid leukemia. The relative incidence of ICH was the highest in M2 and M5 (60.1%). ICH presented with higher peripheral blood white blood cell count (WBC) (P<0.001), lower peripheral platelet counts (P<0.001), lower albumin (P<0.001), lower fibrous protein (P<0.001) and prolongation of prothrombin time (P<0.001) compared to those observed in the patients of NICH group; multivariate analysis, independent risk factors for death in patients with ICH include: WBC≥30.00×109/l and prothrombin time≥12.91 s. CONCLUSIONS:Leukocytosis and coagulation dysfunctions might be the main pathogenesis of acute leukemia complicated with cerebral hemorrhage.
Authors: Loes L Cornelissen; Aukje L Kreuger; Camila Caram-Deelder; Rutger A Middelburg; Jean Louis H Kerkhoffs; Peter A von dem Borne; Erik A M Beckers; Karen M K de Vooght; Jürgen Kuball; J J Zwaginga; Johanna G van der Bom Journal: Ann Hematol Date: 2020-10-17 Impact factor: 3.673