[Superior sagittal sinus thrombosis during remission induction therapy for acute lymphoblastic leukemia]

Rinsho Ketsueki. 2006 Dec;47(12):1533-8.
[Article in Japanese]

Abstract

Superior sagittal sinus thrombosis (SSST) has been reported to be caused by coagulopathy following oral contraceptive therapy, DIC, infection around the sinus, compression from a tumor, infiltration of tumor, and an inherited deficiency of proteins C and S, but SSST associated with hematological malignancies and L-asparaginase (L-Asp) therapy is rare. We report a case of an adult patient with acute lymphoblastic leukemia (ALL) who developed SSST during the remission induction therapy. A 25-year-old man was admitted with left facial nerve palsy and, following bone marrow aspiration and lumbar puncture, he was diagnosed as having T-ALL with CNS involvement. He received a 1-AdVP regimen as remission induction therapy and intrathecal administration of methotrexate and cytarabine. On day 29, he had a generalized convulsion and SSST was demonstrated by imaging tests. Lymphoid malignancy (ALL in particular), the use of L-Asp, CNS involvement, and intrathecal chemotherapy might be risk factors for the occurrence SSST. When a patient with those factors develops any neurological symptoms, we should pay attention to the occurrence of SSST, as well as stroke or CNS involvement, though SSST is rare.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Asparaginase / administration & dosage*
  • Asparaginase / adverse effects*
  • Central Nervous System Neoplasms / complications
  • Central Nervous System Neoplasms / therapy*
  • Cyclophosphamide / administration & dosage
  • Cytarabine / administration & dosage
  • Cytarabine / adverse effects
  • Doxorubicin / administration & dosage
  • Facial Paralysis / etiology
  • Humans
  • Injections, Spinal
  • Male
  • Methotrexate / administration & dosage
  • Methotrexate / adverse effects
  • Mitoxantrone / administration & dosage
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Prednisolone / administration & dosage
  • Remission Induction
  • Risk Factors
  • Sagittal Sinus Thrombosis / etiology*
  • Vincristine / administration & dosage

Substances

  • Cytarabine
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisolone
  • Mitoxantrone
  • Asparaginase
  • Methotrexate