TY  - JOUR
A1  - Koschade-Rixner, Sebastian E.
A1  - Stratmann, Jan Alexander
A1  - Miesbach, Wolfgang
A1  - Steffen, Björn
A1  - Serve, Hubert
A1  - Finkelmeier, Fabian
A1  - Brandts, Christian Hubertus
A1  - Ballo, Olivier Karl Friedrich
T1  - Intracranial hemorrhage in newly diagnosed non-promyelocytic acute myeloid leukemia patients admitted for intensive induction chemotherapy
T2  - European journal of haematology
N2  - 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.
KW  - AML
KW  - bleeding
KW  - induction chemotherapy
KW  - intracranial hemorrhage
KW  - platelet substitution
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/75150
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-751507
SN  - 1600-0609
VL  - 108
IS  - 2
SP  - 125
EP  - 132
PB  - Wiley-Blackwell
CY  - Oxford
ER  -