Dural Venous Sinus Thrombosis in Acute Lymphoblastic Leukemia

PEDIATRICS ◽  
1980 ◽  
Vol 66 (6) ◽  
pp. 943-947
Author(s):  
Lawrence A. Lockman ◽  
Angeline Mastri ◽  
John R. Priest ◽  
Mark Nesbit
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Childhood Leukemia ◽  
Sinus Thrombosis ◽  
Lymphoblastic Leukemia ◽  
Leukemic Cells ◽  
Intracerebral Hematoma ◽  
Sagittal Sinus ◽  
Dural Venous Sinus ◽  
Dural Venous Sinus Thrombosis ◽  
Sagittal Sinus Thrombosis

Three children with acute lymphoblastic leukemia developed sagittal sinus thrombosis. One patient was in peripheral remission. One patient survived. In neither patient who died were the walls of the dural sinuses infiltrated with leukemic cells. Attention is drawn to this potentially treatable cause of central nervous system symptoms in childhood leukemia. Angiography is the diagnostic test of choice and can also demonstrate intracerebral hematoma and subdural hematoma, if present. Sinus thrombosis can occur either during exacerbation or remission of the basic leukemic process. The possibility that chemotherapeutic techniques predispose toward this complication is raised.

Superior sagittal sinus thrombosis with intracerebral hematoma

1987 ◽  
Vol 11 (4) ◽  
pp. 199-202 ◽  
Author(s):  
Gregory K. Gum ◽  
Yuji Numaguchi ◽  
Richard W. Foster ◽  
Didier Cros ◽  
Arvin E. Robinson
Keyword(s):  
Superior Sagittal Sinus ◽  
Sinus Thrombosis ◽  
Intracerebral Hematoma ◽  
Sagittal Sinus ◽  
Sagittal Sinus Thrombosis ◽  
Superior Sagittal Sinus Thrombosis

Abstract TP329: Venous Collateral Drainage Patterns Predict Clinical Worsening in Dural Venous Sinus Thrombosis

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Sunil A Sheth ◽  
Harry Trieu ◽  
David S Liebeskind ◽  
Jeffrey L Saver ◽  
Viktor Szeder ◽  
...  
Keyword(s):  
Sinus Thrombosis ◽  
Complete Recovery ◽  
Transverse Sinus ◽  
Venous Hypertension ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
Sagittal Sinus ◽  
Dural Venous Sinus ◽  
Dural Venous Sinus Thrombosis ◽  
Clinical Worsening

Background: Dural venous sinus thrombosis (DVST) is an increasingly recognized cause of a wide array of neurological symptoms, with outcomes that range from complete recovery to death. Approximately 23% of patients with DVST will worsen after initial presentation, as a result of restricted venous outflow and venous hypertension, but early identification of this subset is challenging. A venous collateral scale (VCS) that grades alternative drainage routes may improve prediction of clinical deterioration. Methods: From our institutional database, we identified patients with documented DVST on dedicated venous imaging (MR, CT or catheter angiography) from January 2010 to July 2016. Patients were excluded for thrombosis related to arteriovenous fistulae. The VCS (Table) was created and scores were determined from cerebrovascular venous imaging at presentation by two reviewers blinded to subsequent imaging and clinical data. Results: Among 28 patients that met criteria, median age was 42 (IQR 24-57) and 50% (14/28) were female. Presentation symptoms included intracranial hemorrhage in 40% (11/28) and headache without hemorrhage in 18% (5/28). Transverse sinus occlusion was present in 68% (19/28), and superior sagittal sinus occlusion in 39% (11/28). 82% (23/28) of patients were treated with anticoagulation, and 18% (5/28) with endovascular thrombectomy. New hemorrhage or expansion of initial hemorrhage occurred in 21% (6/28). In-hospital mortality occurred in 18% (5/28). VCS was 0 in 18% (5/28), 1 in 39% (11/28), and 2 in 46% (12/28). Lower VCS was significantly associated with development of new hemorrhage or expansion of initial hemorrhage (62% vs. 0%, VCS 0-1 vs. 2, p<0.01). VCS demonstrated excellent discrimination for in-hospital clinical worsening (C-statistic 0.85). Conclusions: The type and quality of venous collaterals influence outcome in DVST. VCS helps identify patients who are likely to deteriorate and may need additional early interventions.

Protracted and Variable Latency of Acute Lymphoblastic Leukemia AfterTEL-AML1 Gene Fusion In Utero

Blood ◽  
1999 ◽  
Vol 94 (3) ◽  
pp. 1057-1062 ◽  
Author(s):  
Joseph L. Wiemels ◽  
Anthony M. Ford ◽  
Elisabeth R. Van Wering ◽  
Aleida Postma ◽  
Mel Greaves
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Childhood Leukemia ◽  
Lymphoblastic Leukemia ◽  
In Utero ◽  
Leukemic Cells ◽  
Long Distance ◽  
History Of Childhood ◽  
History Of ◽  
Leukemic Clone ◽  
Pcr Method

We report a pair of identical twins with concordant acute lymphoblastic leukemia (ALL). Unusually, their diagnoses were spaced 9 years apart at ages 5 and 14. Leukemic cells in both twins had aTEL-AML1 rearrangement, which was characterized at the DNA level by an adaptation of a long distance polymerase chain reaction (PCR) method. The genomic fusion sequence was identical in the two leukemias, indicative of a single cell origin in one fetus, in utero. At the time twin 1 was diagnosed (aged 5 years), the bone marrow of twin 2 was hematologically normal. However, retrospective scrutiny of the DNA from an archived slide with clonotypic TEL-AML1 primers showed that the presumptive preleukemic clone was present and disseminated 9 years before a clinical diagnosis. These data provide novel insight into the natural history of childhood leukemia and suggest that consequent to a prenatal initiation of a leukemic clone, most probably by TEL-AML fusion itself, the latency of ALL can be both extremely variable and protracted. This, in turn, is likely to reflect the timing of critical secondary events.

Acute Lymphoblastic Leukemia in Japanese Adolescents; Biology and Toxicity Profile

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4290-4290
Author(s):  
So-ichi Suenobu ◽  
Atsushi Sato ◽  
Yoshihiro Takahashi ◽  
Ikuya Usami ◽  
Shin-ichiro Nishimura ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Childhood Leukemia ◽  
Conflicts Of Interest ◽  
Lymphoblastic Leukemia ◽  
Treatment Compliance ◽  
Leukemic Cells ◽  
Rank Test ◽  
Adolescent Group ◽  
Younger Patients ◽  
Japanese Adolescents

Abstract Abstract 4290 BACKGROUND In the treatment for acute lymphoblastic leukemia (ALL), adolescents were reported to have worse prognosis than children because of their treatment compliance and response. In this study, we compared clinical features, treatment toxicity and outcome between children and adolescents treated with Japan Association of Childhood Leukemia Study (JACLS) ALL-02 protocol. METHODS The dataset of 1246 eligible patients enrolled in the study between April 2002 and May 2008 was analyzed. The patients were assigned into five categories; SR (PGR, age between 1 and 9 years, WBC<10K and no CNS disease, HR (non SR with PGR; SR with t(1;19), 11q23 other than t(4;11), or M3 marrow on day15), ER (PPR, hypodiploid, unclassified, mixed-lineage, HR with M3 marrow on day15), T (T-lineage) and F (non CR on day 33, T with M3 marrow on day15, or t(4;11)). The patients with Ph+ ALL were excluded from this analyze. The data of 249 patients older than 10 years of age (adolescent group) were compared with those of 705 aged 1 to 5 years and 292 aged 6 to 9 years. The adolescent group included 28 patients older than 15 years of age. The survival rate was estimated with Kaplan–Meier method and two –sided log-rank test using SAS version 9.1. RESULTS ETV6-RUNX1 and hyperdiploidy were significantly less frequent in adolescents. The rates of PGR and CR on day 33 in adolescents were significantly lower than those in younger patients (82.7% vs. 90.5%, p<0.01, and 93.1% vs. 97.2%, Ap<0.01, respectively). Five-year overall survival (OS) and event-free survival (EFS) for adolescents were significantly lower than those for children aged 1 to 5 years (78.9% vs. 93.9%, p<0.01, 70.9% vs. 87.5%, p<0.01, respectively). In comparison of adverse effects between adolescent and children groups treated with HR protocol, Grade III and IV neurotoxicity was more frequently observed in adolescents than younger patients (1.99% vs. 0.39%, p<0.01) while infection, pancreatitis or liver toxicity was not significantly different between the two groups. CONCLUSIONS The results indicated that poorer outcome in adolescents with ALL may not result from severe treatment toxicities, but link with some specific biology of the leukemic cells. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Baicalein Triggers Mitochondria-Mediated Apoptosis and Enhances the Antileukemic Effect of Vincristine in Childhood Acute Lymphoblastic Leukemia CCRF-CEM Cells

2013 ◽  
Vol 2013 ◽  
pp. 1-19 ◽  
Author(s):  
Yun-Ju Chen ◽  
Chieh-Shan Wu ◽  
Jeng-Jer Shieh ◽  
Jyh-Horng Wu ◽  
Hsing-Yu Chen ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Therapeutic Efficacy ◽  
Childhood Leukemia ◽  
Lymphoblastic Leukemia ◽  
Death Receptor ◽  
Leukemic Cells ◽  
Combination Strategy ◽  
Pediatric Leukemia ◽  
Beneficial Effects ◽  
First Time

Acute lymphoblastic leukemia (ALL) accounts for approximately 75% of childhood leukemia, and chemotherapy remains the mainstay therapy. Baicalein is an active flavonoid used in traditional Chinese medicine and has recently been found to have anticancer, anti-inflammatory, and antiallergic properties. This study aims to investigate the molecular apoptotic mechanisms of baicalein in CCRF-CEM leukemic cells and to evaluate the combined therapeutic efficacy of baicalein with several commonly used chemotherapeutic drugs in CCRF-CEM cells. Our results demonstrate that baicalein induces mitochondria-dependent cleavage of caspases-9 and -3 and PARP with concomitant decreases in IAP family proteins, survivin, and XIAP. Furthermore, our results present for the first time that baicalein triggers a convergence of the intrinsic and extrinsic apoptotic pathways via the death receptor-caspase 8-tBid signaling cascade in CCRF-CEM cells. In addition, we also present for the first time that the combination of baicalein and vincristine results in a synergistic therapeutic efficacy. Overall, this combination strategy is recommended for future clinical trials in the treatment of pediatric leukemia owing to baicalein’s beneficial effects in alleviating the vomiting, nausea, and skin rashes caused by chemotherapy.

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