Intracranial hemorrhage in newly diagnosed non-promyelocytic acute myeloid leukemia patients admitted for intensive induction chemotherapy

  • Objectives and Methods: Intracranial hemorrhage (ICH) in acute myeloid leukemia (AML) patients is a major concern due to the increased risk of mortality. Few studies have examined ICH specifically in newly diagnosed AML patients receiving intensive induction chemotherapy (IC) and prophylactic platelet transfusions during thrombocytopenia <10/nL. This retrospective cohort study included 423 newly diagnosed AML patients without acute promyelocytic leukemia who underwent IC between 2007 and 2019. We assessed risk factors, clinical features, and outcomes of ICH. Results: 17 of 423 patients (4%) suffered ICH during hospital stay, and 4 patients (24%) died directly because of ICH despite routine prophylactic platelet transfusions. Patients with ICH had a negatively impacted overall survival (median OS, 20.1 vs. 104.8 months) and were more likely not to continue with curative treatment. Main risk factors were female gender, severe thrombocytopenia, and decreased fibrinogen. Patients with subsequent ICH also had laboratory signs of liver dysfunction. Conclusions: Intracranial hemorrhage remains a potentially deadly complication with notable incidence despite prophylactic platelet substitution, suggesting that additional prophylactic interventions may be required to further reduce the frequency of ICH in high-risk patients. Unrecognized genetic factors may simultaneously predispose to AML and platelet dysfunction with ICH.
Author:Sebastian E. Koschade-RixnerORCiDGND, Jan Alexander StratmannORCiDGND, Wolfgang MiesbachORCiDGND, Björn SteffenGND, Hubert ServeORCiDGND, Fabian FinkelmeierORCiDGND, Christian Hubertus BrandtsORCiDGND, Olivier Karl Friedrich BalloORCiDGND
Parent Title (English):European journal of haematology
Place of publication:Oxford
Document Type:Article
Date of Publication (online):2021/10/29
Date of first Publication:2021/10/29
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2023/08/17
Tag:AML; bleeding; induction chemotherapy; intracranial hemorrhage; platelet substitution
Page Number:8
First Page:125
Last Page:132
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - CC BY-NC-ND - Namensnennung - Nicht kommerziell - Keine Bearbeitungen 4.0 International