Recurrent peripheral arterial occlusion by leukemic cells sedimentation in acute promyelocytic leukemia

Fass, Robert J.; Haddad, M; Zaizov, Rina; Sandbank, Y.; Yaniv, I.; Cohen, Ian J.; Stark, Batia; Zelikovski, A

doi:10.1016/0022-3468(92)90475-m

Cited by 25 publications

(22 citation statements)

References 5 publications

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“…Our findings do not firmly support the hypothesis of a special role of hyperleukocytosis as triggering factor for vessel occlusion in acute leukemia [43,44], in agreement with other systematic observations [11].…”

Section: Discussioncontrasting

confidence: 70%

The risk of thrombosis in patients with acute leukemia: occurrence of thrombosis at diagnosis and during treatment

Stefano¹,

Sorà²,

Rossi³

et al. 2005

Journal of Thrombosis and Haemostasis

219

165

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Summary. Background: Thromboembolism can occur during acute leukemia, especially acute lymphoid leukemia (ALL) treated with l‐asparaginase. Yet, most reports are anecdotical and scarce data are available on the risk of thrombosis in acute myeloid leukemia (AML). Objectives: To evaluate the risk of thrombosis in patients with acute leukemia. Patients and methods: Three‐hundred and seventy‐nine consecutive adult patients with newly diagnosed acute leukemia were recruited in an observational cohort study conducted from January 1994 to December 2003. Diagnosis was ALL in 69 patients, acute promyelocytic leukemia (APL; FAB subtype M3) in 31, and non‐M3 AML in 279. All first or recurrent symptomatic thromboembolic events objectively diagnosed were recorded. Results: Twenty‐four patients of the overall 379 (6.3%; 95% CI 4.1%–9.2%) had a first thrombosis, venous in 80% of the cases and arterial in 20%. At diagnosis, thrombosis was a presenting manifestation in 13 cases (3.4% of the whole cohort): 1.4% in ALL, 9.6% in APL, and 3.2% in non‐M3 AML patients. Follow‐up was carried out on 343 patients without thrombosis at diagnosis and further 11 thrombotic events (3.2%) were recorded. At 6 months from diagnosis, the cumulative incidence of thrombosis was 10.6% in ALL, 8.4% in APL, and 1.7% in non‐M3 AML patients. The patients who received l‐asparaginase had a 4.9‐fold increased risk of thrombosis in comparison with those who did not (95% CI 1.5–16.0). The fatality rate due to thrombosis was 0.8%. Conclusions: In patients with acute leukemia, the risk of thrombosis is not negligible. Thombosis can be a presenting symptom at diagnosis in a significant portion of cases with APL (9.6%) and non‐M3 AML (3.2%); a similar rate of thrombosis can occur during the subsequent course of the disease. The incidence of symptomatic thrombosis at diagnosis is relatively low in ALL patients (1.4%), but is significantly increased by further treatment up to 10.6%. Strategies of antithrombotic prophylaxis should be investigated in this setting.

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Section: Discussioncontrasting

confidence: 70%

The risk of thrombosis in patients with acute leukemia: occurrence of thrombosis at diagnosis and during treatment

Stefano¹,

Sorà²,

Rossi³

et al. 2005

Journal of Thrombosis and Haemostasis

219

165

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“…Acute arterial thrombosis localized to the large blood vessels is rare at presentation, as bleeding manifestations tend to predominate. Our literature search revealed eight other case reports of large vessel thrombosis as the presenting feature of APL (Delodovici et al, 1991;Fass et al, 1992;Kardos et al, 1992;Quadir et al, 1993;Re et al, 1995;Saitoh et al, 1995;Rolston et al, 1998;DiGiovanni et al, 1999) reported since 1991. Possible predisposing factors identified from these reports include high peripheral blood and bone marrow blast counts (Saitoh et al, 1995).…”

Section: Discussionmentioning

confidence: 93%

“…Our literature search revealed eight other case reports of large vessel thrombosis as the presenting feature of APL (Delodovici et al. , 1991; Fass et al. , 1992; Kardos et al.…”

Section: Discussionmentioning

confidence: 95%

Acute arterial thrombosis in acute promyelocytic leukaemia

Kalk¹,

Goede

Rose³

2003

Clinical &Amp; Laboratory Haematology

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“…11 This case highlights the possibility of enhanced muscle and nerve recovery in the pediatric population following prolonged limb ischemia. Longer ischemia times and more advanced muscle changes may be tolerated or recoverable.…”

Section: Discussionmentioning

confidence: 92%

Functional Limb Salvage Following Muscle Rigor in a Pediatric Patient

Dickinson¹,

Jiménez²,

Lawrence³

et al. 2010

Vasc Endovascular Surg

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Acute limb-threatening ischemia is a vascular surgical emergency. Traditionally, 4 to 6 hours are usually available from the onset of acute ischemia to successfully revascularize before irreversible damage occurs. The presence of ischemic rigor traditionally represents irreparable local damage to muscle in the adult population and is an indication for limb amputation. Although the literature is scarce on this topic, few authors have reported superior limb salvage rates in pediatric patients despite the presence of severely impaired arterial perfusion. We present a case of a 10-year-old girl with rigor of the left lower extremity, who underwent surgical reperfusion for acute ischemia approximately 14 hours after the initiation of symptoms. The patient presented with an insensate and paralyzed limb. Pulsatile flow was restored to her lower extremity. She regained protective sensation and suffered no significant sequelae of systemic reperfusion syndrome.

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Recurrent peripheral arterial occlusion by leukemic cells sedimentation in acute promyelocytic leukemia

Cited by 25 publications

References 5 publications

The risk of thrombosis in patients with acute leukemia: occurrence of thrombosis at diagnosis and during treatment

The risk of thrombosis in patients with acute leukemia: occurrence of thrombosis at diagnosis and during treatment

Acute arterial thrombosis in acute promyelocytic leukaemia

Functional Limb Salvage Following Muscle Rigor in a Pediatric Patient

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