Central nervous system thrombosis in pediatric acute lymphoblastic leukemia in Turkey: A multicenter study

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dc.contributor.authorGuzelkucuk, Zeliha
dc.contributor.authorKarapinar, Deniz Yilmaz
dc.contributor.authorGelen, Sema Aylan
dc.contributor.authorTokgoz, Huseyin
dc.contributor.authorOzcan, Alper
dc.contributor.authorAy, Yilmaz
dc.contributor.authorBahadir, Aysenur
dc.date.accessioned2024-02-23T13:03:29Z
dc.date.available2024-02-23T13:03:29Z
dc.date.issued2023
dc.departmentNEÜen_US
dc.description.abstractBackgroundIn patients with acute lymphoblastic leukemia (ALL), the risk of thromboembolism increases due to hemostatic changes secondary to the primary disease and due to treatment-related factors. In this multicenter study, we aimed to research the frequency of central nervous system (CNS) thrombosis occurring during treatment, hereditary and acquired risk factors, clinical and laboratory features of patients with thrombosis, treatment approaches, and thrombosis-related mortality and morbidity rates in pediatric ALL patients. ProcedurePediatric patients who developed CNS thrombosis during ALL treatment from 2010 to 2021 were analyzed retrospectively in 25 different Pediatric Hematology Oncology centers in Turkiye. The demographic characteristics of the patients, symptoms associated with thrombosis, the stage of the leukemia treatment during thrombosis, the anticoagulant therapy applied for thrombosis, and the final status of the patients recorded through electronic medical records were determined. ResultsData from 70 patients with CNS thrombosis during treatment, out of 3968 pediatric patients with ALL, were reviewed. The incidence of CNS thrombosis was 1.8% (venous: 1.5 %; arterial: 0.03%). Among patients with CNS thrombosis, 47 had the event in the first 2 months. Low molecular weight heparin (LMWH) was the most commonly used treatment with a median of 6 months (min-max: 3-28 months). No treatment-related complications occurred. Chronic thrombosis findings occurred in four patients (6%). In five (7%) patients who developed cerebral vein thrombosis, neurological sequelae (epilepsy and neurological deficit) remained. One patient died related to thrombosis, and the mortality rate was 1.4%. ConclusionCerebral venous thrombosis and, less frequently, cerebral arterial thrombosis may develop in patients with ALL. The incidence of CNS thrombosis is higher during induction therapy than during other courses of treatment. Therefore, patients receiving induction therapy should be monitored carefully for clinical findings suggestive of CNS thrombosis.en_US
dc.identifier.doi10.1002/pbc.30425
dc.identifier.issn1545-5009
dc.identifier.issn1545-5017
dc.identifier.issue8en_US
dc.identifier.pmid37194482en_US
dc.identifier.scopus2-s2.0-85159460406en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://doi.org/10.1002/pbc.30425
dc.identifier.urihttps://hdl.handle.net/20.500.12452/10635
dc.identifier.volume70en_US
dc.identifier.wosWOS:000988415200001en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherWileyen_US
dc.relation.ispartofPediatric Blood & Canceren_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectAcute Lymphoblastic Leukemiaen_US
dc.subjectCentral Nervous Systemen_US
dc.subjectThrombosisen_US
dc.titleCentral nervous system thrombosis in pediatric acute lymphoblastic leukemia in Turkey: A multicenter studyen_US
dc.typeArticleen_US

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