Cerebral Hemorrhage in Leukemia

Groch, Sigmund N.; Sayre, George P.; Heck, Frank J.

doi:10.1001/archneur.1960.03840100077011

Cited by 43 publications

(10 citation statements)

References 9 publications

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“…This emphasizes the fact that a significant number of intracranial lesions do not manifest during life. The postmortem incidence of central nervous system complications seen in 45 cut of 82 (54.9%) patients in this series is high in comparison to the range from 19.35% to 49% reported in literature [11][12][13]. This variation may be due to a comparatively smaller number of patients' and a selective population studied by us.…”

Section: Discussioncontrasting

confidence: 58%

Leukaemic Involvement of Central Nervous System

Akhtar¹,

Kumar

et al. 1995

Medical Journal Armed Forces India

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Eighty two patients of leukaemia consisting of 25 cases of acute lymphocytic leukaemia, 38 cases of acute myeloid leukaemia, 14 cases of chronic myeloid leukaemia and 5 cases of chronic lymphocytic leukaemia were evaluated for central nervous system (eNS) involvement. Speech disorders, cranial nerve palsies, encephalopathy, ataxia, intracranial haemorrhage, peripheral neuropathy and spinal cord involvement were the main neurological findings detected in 23 (28.1%) cases. All except one were subjected to autopsy after death. Leukaemic infiltrations (36.6%) and intracranial haemorrhage (26.8%) were the prominent CNS autopsy findings. In addition, demyelination with astrocytosis (9.7%) and gliosis (2.4%) were seen. In all, 45 (54.9%) of the patients showed CNS involvement at autopsy. Thus a large number ofCNS lesions were missed clinically and detected only on autopsy. MJAFI 1995; 51 : 161-164

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Section: Discussioncontrasting

confidence: 58%

Leukaemic Involvement of Central Nervous System

Akhtar¹,

Kumar

et al. 1995

Medical Journal Armed Forces India

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“…9,[16][17][18][19][20][21][22][23][24] Most FICH occurred soon after diagnosis, 27 within 7 days, and 13 patients presented with FICH at diagnosis. Because the median interval from FICH to death was 2 days, we estimate that 1.6% of patients with acute leukemia die from FICH without any opportunity for proper management.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, viral infection of brain endothelial cells has been thought to cause cerebral hemorrhages, 31 but this could not be confirmed clinically. Thrombocytopenia, or platelet counts ranging from 20 000 to 40 000/ml, has been found to be a cause of cerebral hemorrhages, 16,30,32,33 and several centers have a restrictive platelet transfusion policy, with thresholds at 10 000 to 20 000/ml for patients with acute leukemia. 34,35 In contrast, we found that platelet counts less than 35 000/ml increased the risk of FICH.…”

Section: Discussionmentioning

confidence: 99%

Risk score model for fatal intracranial hemorrhage in acute leukemia

Kim

et al. 2006

Leukemia

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To build a risk score (RS) model of fatal intracranial hemorrhage (FICH) in patients with acute leukemia, we retrospectively assessed risk factors in 792 patients newly diagnosed with acute leukemia, 41 of whom had analyzable FICH. We found that female gender (relative risk (RR) ¼ 5.234, Po0.001), acute promyelocytic leukemia (RR ¼ 4.057, P ¼ 0.003), leukocytosis (RR ¼ 3.301, P ¼ 0.004), thrombocytopenia (RR ¼ 3.283, P ¼ 0.005) and prolonged prothrombin time (RR ¼ 3.291, P ¼ 0.016) were significantly associated with occurrence of FICH in multivariate analysis. To calculate RS for FICH, one point was assigned for each risk factor, making the RS between 0 and 5. The RS model segregated patients into three prognostic groups: a low-risk group (LRG) for RS of 0 or 1; an intermediate-risk group (IRG) for RS of 2 or 3; and a high-risk group (HRG) for RS of 4 or 5. Expectation of FICH was well correlated with risk groups (all P-values o0.001). Overall survival was significantly shorter in the HRG compared with the LRG. The RS model we constructed to predict the occurrence of FICH will be verified through prospective studies.

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“…Whereas very early studies had to rely on autopsies to establish a diagnosis of ICH [3], newer imaging modalities such as computed tomography (CT) have made it possible to diagnose ICH more quickly and of smaller sizes. Several studies so far have tried to describe the clinical characteristics of patients with ICH [2–4], but predictors of mortality in patients with leukemia who develop ICH are not available.…”

Section: Introductionmentioning

confidence: 99%

Prediction model for mortality after intracranial hemorrhage in patients with leukemia

et al. 2011

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Intracranial hemorrhage (ICH) is associated with great morbidity and mortality in patients with acute leukemia. We identified 118 patients with ICH from a total of 2,421 patient with leukemia who were treated at our institution between 2005–2009, and assessed the prognostic factors for mortality in the ICH cohort. Median age at time of ICH was 58 years, 49% were male, and 60% had acute myeloid leukemia. The relative incidence of ICH was highest in patients with chronic myeloid leukemia in blast crisis (12.1%). Mental status changes were the most common symptom which prompted work-up for ICH. Median survival for all patients after onset of ICH was 20 days. In multivariate analyses, four clinical characteristics were identified as independent adverse factors for mortality in patients with ICH: albumin <3.5 g/dL, lactate dehydrogenase (LDH) >835 U/L, age > 60 years, and relapsed disease status. Based on the number of risk factors, mortality after ICH was: 25% (0 risk factor), 47% (1), 78% (2), and >97% (3 or 4). In conclusion, patients with leukemia who develop ICH do not have universally poor outcomes, and a simple scoring system could serve to advise physicians and families of the prognosis and the potential benefit of aggressive treatment options.

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Cerebral Hemorrhage in Leukemia

Cited by 43 publications

References 9 publications

Leukaemic Involvement of Central Nervous System

Leukaemic Involvement of Central Nervous System

Risk score model for fatal intracranial hemorrhage in acute leukemia

Prediction model for mortality after intracranial hemorrhage in patients with leukemia

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