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...
Gespeichert in:
| Veröffentlicht in: | Transfusion (Philadelphia, Pa.) Pa.), 2020-02, Vol.60 (2), p.269-274 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 274 |
|---|---|
| container_issue | 2 |
| container_start_page | 269 |
| container_title | Transfusion (Philadelphia, Pa.) |
| container_volume | 60 |
| creator | 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 |
| description | 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 = |
| doi_str_mv | 10.1111/trf.15621 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2322724603</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2322724603</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3531-9690599ba8fb8c4646d3d52f6209fcc743c5aeff6da98ce5cf44c7047c221a683</originalsourceid><addsrcrecordid>eNp10U9LwzAYBvAgipvTg19AAl700Jk_TdocZTgVBEH0XLI0cZlpMpOWsW9vdOpBMJcXwi8PL3kAOMVoivO56qOZYsYJ3gNjzGhVECHYPhgjVOICY0pG4CilFUKICIQPwYjiGtWMozHwM2e9VdLBMPQqdDpB6VvYR-mTGZINHnbSy1fdad9DE5wLG-tfofWZqKxsfrrUXYhxmVW-h2vZ24wT3Nh-CaUaeg2dHt50Z-UxODDSJX3yPSfgZX7zPLsrHh5v72fXD4WijOJCcIGYEAtZm0WtSl7ylraMGE6QMEpVJVVMamN4K0WtNFOmLFWFykoRgiWv6QRc7HLXMbwPOvVNZ5PSzkmvw5AaQgmpSMkRzfT8D12FIfq8XVYMCSQ4x1ld7pSKIaWoTbOOtpNx22DUfJbQ5BKarxKyPftOHBadbn_lz69ncLUDG-v09v-k5vlpvov8AOTWkl4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2350909661</pqid></control><display><type>article</type><title>Clinical outcomes and transfusion management following intracranial hemorrhage in patients with acute leukemia</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>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</creator><creatorcontrib>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</creatorcontrib><description>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 = <0.01). Twenty‐one percent of platelet transfusions were provided when the platelet count was less than 10 x 109/L, 54% between 10 and 29 x 109/L, and 25% greater than 30 x 109/L. New or progressive ICH occurred in 23 patients. There was no difference in the median platelet transfusion trigger between patients who had new or progressive ICH and those who did not.
CONCLUSION
In patients with acute leukemia, survival following ICH is poor. Older age and higher white count is associated with increased mortality, perhaps reflecting higher risk disease. Following ICH in acute leukemia platelet transfusions do not appear to alter the risk of progressive bleeding or mortality.</description><identifier>ISSN: 0041-1132</identifier><identifier>EISSN: 1537-2995</identifier><identifier>DOI: 10.1111/trf.15621</identifier><identifier>PMID: 31808560</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Bleeding ; Blood platelets ; Clinical outcomes ; Health risks ; Hemorrhage ; Leukemia ; Mortality ; Platelets ; Remission ; Survival ; Therapy ; Transfusion</subject><ispartof>Transfusion (Philadelphia, Pa.), 2020-02, Vol.60 (2), p.269-274</ispartof><rights>2019 AABB</rights><rights>2019 AABB.</rights><rights>2020 AABB</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3531-9690599ba8fb8c4646d3d52f6209fcc743c5aeff6da98ce5cf44c7047c221a683</citedby><cites>FETCH-LOGICAL-c3531-9690599ba8fb8c4646d3d52f6209fcc743c5aeff6da98ce5cf44c7047c221a683</cites><orcidid>0000-0002-4598-9380</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Ftrf.15621$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Ftrf.15621$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31808560$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nixon, Shannon</creatorcontrib><creatorcontrib>Lieberman, Lani</creatorcontrib><creatorcontrib>Atenafu, Eshetu G.</creatorcontrib><creatorcontrib>Doherty, Mary</creatorcontrib><creatorcontrib>Murray, Cindy</creatorcontrib><creatorcontrib>Wolfe, Amanda</creatorcontrib><creatorcontrib>Brandys, Danielle</creatorcontrib><creatorcontrib>Rowland, Suzanne</creatorcontrib><creatorcontrib>Kwan, Benjamin YM</creatorcontrib><creatorcontrib>Yu, Eugene</creatorcontrib><creatorcontrib>Lechner, Breanne</creatorcontrib><creatorcontrib>Maze, Dawn</creatorcontrib><title>Clinical outcomes and transfusion management following intracranial hemorrhage in patients with acute leukemia</title><title>Transfusion (Philadelphia, Pa.)</title><addtitle>Transfusion</addtitle><description>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 = <0.01). Twenty‐one percent of platelet transfusions were provided when the platelet count was less than 10 x 109/L, 54% between 10 and 29 x 109/L, and 25% greater than 30 x 109/L. New or progressive ICH occurred in 23 patients. There was no difference in the median platelet transfusion trigger between patients who had new or progressive ICH and those who did not.
CONCLUSION
In patients with acute leukemia, survival following ICH is poor. Older age and higher white count is associated with increased mortality, perhaps reflecting higher risk disease. Following ICH in acute leukemia platelet transfusions do not appear to alter the risk of progressive bleeding or mortality.</description><subject>Bleeding</subject><subject>Blood platelets</subject><subject>Clinical outcomes</subject><subject>Health risks</subject><subject>Hemorrhage</subject><subject>Leukemia</subject><subject>Mortality</subject><subject>Platelets</subject><subject>Remission</subject><subject>Survival</subject><subject>Therapy</subject><subject>Transfusion</subject><issn>0041-1132</issn><issn>1537-2995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp10U9LwzAYBvAgipvTg19AAl700Jk_TdocZTgVBEH0XLI0cZlpMpOWsW9vdOpBMJcXwi8PL3kAOMVoivO56qOZYsYJ3gNjzGhVECHYPhgjVOICY0pG4CilFUKICIQPwYjiGtWMozHwM2e9VdLBMPQqdDpB6VvYR-mTGZINHnbSy1fdad9DE5wLG-tfofWZqKxsfrrUXYhxmVW-h2vZ24wT3Nh-CaUaeg2dHt50Z-UxODDSJX3yPSfgZX7zPLsrHh5v72fXD4WijOJCcIGYEAtZm0WtSl7ylraMGE6QMEpVJVVMamN4K0WtNFOmLFWFykoRgiWv6QRc7HLXMbwPOvVNZ5PSzkmvw5AaQgmpSMkRzfT8D12FIfq8XVYMCSQ4x1ld7pSKIaWoTbOOtpNx22DUfJbQ5BKarxKyPftOHBadbn_lz69ncLUDG-v09v-k5vlpvov8AOTWkl4</recordid><startdate>202002</startdate><enddate>202002</enddate><creator>Nixon, Shannon</creator><creator>Lieberman, Lani</creator><creator>Atenafu, Eshetu G.</creator><creator>Doherty, Mary</creator><creator>Murray, Cindy</creator><creator>Wolfe, Amanda</creator><creator>Brandys, Danielle</creator><creator>Rowland, Suzanne</creator><creator>Kwan, Benjamin YM</creator><creator>Yu, Eugene</creator><creator>Lechner, Breanne</creator><creator>Maze, Dawn</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4598-9380</orcidid></search><sort><creationdate>202002</creationdate><title>Clinical outcomes and transfusion management following intracranial hemorrhage in patients with acute leukemia</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3531-9690599ba8fb8c4646d3d52f6209fcc743c5aeff6da98ce5cf44c7047c221a683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Bleeding</topic><topic>Blood platelets</topic><topic>Clinical outcomes</topic><topic>Health risks</topic><topic>Hemorrhage</topic><topic>Leukemia</topic><topic>Mortality</topic><topic>Platelets</topic><topic>Remission</topic><topic>Survival</topic><topic>Therapy</topic><topic>Transfusion</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nixon, Shannon</creatorcontrib><creatorcontrib>Lieberman, Lani</creatorcontrib><creatorcontrib>Atenafu, Eshetu G.</creatorcontrib><creatorcontrib>Doherty, Mary</creatorcontrib><creatorcontrib>Murray, Cindy</creatorcontrib><creatorcontrib>Wolfe, Amanda</creatorcontrib><creatorcontrib>Brandys, Danielle</creatorcontrib><creatorcontrib>Rowland, Suzanne</creatorcontrib><creatorcontrib>Kwan, Benjamin YM</creatorcontrib><creatorcontrib>Yu, Eugene</creatorcontrib><creatorcontrib>Lechner, Breanne</creatorcontrib><creatorcontrib>Maze, Dawn</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transfusion (Philadelphia, Pa.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nixon, Shannon</au><au>Lieberman, Lani</au><au>Atenafu, Eshetu G.</au><au>Doherty, Mary</au><au>Murray, Cindy</au><au>Wolfe, Amanda</au><au>Brandys, Danielle</au><au>Rowland, Suzanne</au><au>Kwan, Benjamin YM</au><au>Yu, Eugene</au><au>Lechner, Breanne</au><au>Maze, Dawn</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical outcomes and transfusion management following intracranial hemorrhage in patients with acute leukemia</atitle><jtitle>Transfusion (Philadelphia, Pa.)</jtitle><addtitle>Transfusion</addtitle><date>2020-02</date><risdate>2020</risdate><volume>60</volume><issue>2</issue><spage>269</spage><epage>274</epage><pages>269-274</pages><issn>0041-1132</issn><eissn>1537-2995</eissn><abstract>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 = <0.01). Twenty‐one percent of platelet transfusions were provided when the platelet count was less than 10 x 109/L, 54% between 10 and 29 x 109/L, and 25% greater than 30 x 109/L. New or progressive ICH occurred in 23 patients. There was no difference in the median platelet transfusion trigger between patients who had new or progressive ICH and those who did not.
CONCLUSION
In patients with acute leukemia, survival following ICH is poor. Older age and higher white count is associated with increased mortality, perhaps reflecting higher risk disease. Following ICH in acute leukemia platelet transfusions do not appear to alter the risk of progressive bleeding or mortality.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>31808560</pmid><doi>10.1111/trf.15621</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-4598-9380</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0041-1132 |
| ispartof | Transfusion (Philadelphia, Pa.), 2020-02, Vol.60 (2), p.269-274 |
| issn | 0041-1132 1537-2995 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2322724603 |
| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Bleeding Blood platelets Clinical outcomes Health risks Hemorrhage Leukemia Mortality Platelets Remission Survival Therapy Transfusion |
| title | Clinical outcomes and transfusion management following intracranial hemorrhage in patients with acute leukemia |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-21T18%3A57%3A27IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Clinical%20outcomes%20and%20transfusion%20management%20following%20intracranial%20hemorrhage%20in%20patients%20with%20acute%20leukemia&rft.jtitle=Transfusion%20(Philadelphia,%20Pa.)&rft.au=Nixon,%20Shannon&rft.date=2020-02&rft.volume=60&rft.issue=2&rft.spage=269&rft.epage=274&rft.pages=269-274&rft.issn=0041-1132&rft.eissn=1537-2995&rft_id=info:doi/10.1111/trf.15621&rft_dat=%3Cproquest_cross%3E2322724603%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2350909661&rft_id=info:pmid/31808560&rfr_iscdi=true |