Clinical outcomes and transfusion management following intracranial hemorrhage in patients with acute leukemia

BACKGROUND There is little evidence to guide management of patients with acute leukemia and intracranial hemorrhage (ICH). Predictors of long‐term outcome following ICH are unknown. STUDY DESIGN AND METHODS This study included adult patients with acute leukemia and ICH over an 8‐year period. The pri...

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Published in:Transfusion (Philadelphia, Pa.) Pa.), 2020-02, Vol.60 (2), p.269-274
Main Authors: Nixon, Shannon, Lieberman, Lani, Atenafu, Eshetu G., Doherty, Mary, Murray, Cindy, Wolfe, Amanda, Brandys, Danielle, Rowland, Suzanne, Kwan, Benjamin YM, Yu, Eugene, Lechner, Breanne, Maze, Dawn
Format: Article
Language:English
Subjects:
Bleeding
Blood platelets
Clinical outcomes
Health risks
Hemorrhage
Leukemia
Mortality
Platelets
Remission
Survival
Therapy
Transfusion
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Summary:BACKGROUND There is little evidence to guide management of patients with acute leukemia and intracranial hemorrhage (ICH). Predictors of long‐term outcome following ICH are unknown. STUDY DESIGN AND METHODS This study included adult patients with acute leukemia and ICH over an 8‐year period. The primary outcome was data regarding 90‐day mortality. Secondary outcomes included data related to the proportion of patients receiving post‐remission therapy and predictors of 90‐day mortality. RESULTS ICH occurred in 101 patients; 12 patients died within 72 hours. For the 89 others, 90‐day mortality was 40%. Of 43 patients who received induction, 30 achieved remission and 26 received post‐remission therapy. Older age (p = 0.03) and higher white count (p = 0.02) at the time of ICH were predictive of inferior survival. During 90‐day follow‐up, median platelet count was 37 x 109/L (0‐1526 x 109/L). Lower platelet count during follow‐up was predictive of 90‐day mortality (p =
ISSN:0041-1132
1537-2995
DOI:10.1111/trf.15621