Kamoga Doreen, Desikan Sai, Desikan Raman, Musuuza Jackson
Department of Internal Medicine White River Health Batesville Arkansas USA.
MD Anderson Cancer Center Houston Texas USA.
Clin Case Rep. 2024 Mar 13;12(3):e8601. doi: 10.1002/ccr3.8601. eCollection 2024 Mar.
Acute leukemia, particularly AML, is closely associated with thrombotic events, driven by complex factors like coagulation system changes, endothelial dysfunction, and leukemic cell interactions with the vascular system. Certain chemotherapy drugs can exacerbate the prothrombotic state. Understanding these dynamics is crucial for effective thromboprophylaxis in carefully selected patients with leukemia.
Thrombosis is a significant complication of acute leukemia. Thrombotic events mostly occur at diagnosis or during induction therapy. Here we report the occurrence of myocardial infarction (MI) before initiation of therapy, in a patient with acute myeloid leukemia not otherwise specified (AML NOS) who had no other significant risk factors for coronary artery disease. The occurrence of MI in this patient limited the choice of induction therapy and resulted in mortality. We discuss the pathogenesis and risk factors associated with increased thrombosis in AML and advocate for risk-adapted thromboprophylaxis in this patient population.
急性白血病，尤其是急性髓系白血病（AML），与血栓形成事件密切相关，这是由凝血系统变化、内皮功能障碍以及白血病细胞与血管系统的相互作用等复杂因素驱动的。某些化疗药物会加剧血栓前状态。了解这些动态变化对于精心挑选的白血病患者进行有效的血栓预防至关重要。
血栓形成是急性白血病的一种重要并发症。血栓事件大多发生在诊断时或诱导治疗期间。在此，我们报告一例未另行指定的急性髓系白血病（AML NOS）患者在开始治疗前发生心肌梗死（MI），该患者无其他冠状动脉疾病的显著危险因素。该患者发生心肌梗死限制了诱导治疗的选择并导致死亡。我们讨论了与AML中血栓形成增加相关的发病机制和危险因素，并提倡对该患者群体进行风险适应性血栓预防。
