Analysis of life-threatening central never system complications of acute leukemia in 26 children / 中华实用儿科临床杂志

ABSTRACT

Objective To investigate the clinical characteristics and risk factors of childhood acute leukemia (AL) with severe neurologic complications.Methods From Jun.1991 to Mar.2011,26 AL patients with severe neurologic complications in Peking University People's Hospital were enrolled.The incidence,clinical features,and risk factors for severe neurologic complications were retrospectively analyzed.Results There 26 patients included 8 cases of acute lymphoblastic leukemia,17 cases of acute myeloid leukemia(AML) and 1 case of acute mixed lineage leukemia.There were 20 patients taking CT scan and 17 patients were confirmed with intracranial hemorrhage.Six cases of AML without CT scan were dead.The patients suffering from intracranial hemorrhage all had intraparenchymal hemorrhage.The AML-M5 with intracranial hemorrhage had higher white blood cell count and higher level of L-lactate dehydrogenase than those without intracranial hemorrhage.These were 5 cases(31.25％) of AML with platelet count ＜ 20 × 109/L,12 cases(70.58％) of AML with prolonged prothrombin time,7 cases(41.17％) of AML with prolonged activated partial thromboplastin time,and 8 cases(47.06％) of AML with low fibrinogen when the severe neurologic complication occurred.Conclusions The most common type of severe neurologic complications of childhood AL is intracranial hemorrhage.The patients with AML are prone to occur intracranial hemorrhage.Intensive blood production transfusion may be beneficial to reduce the probability of intracranial hemorrhage in these patients.