Priest J R, Ramsay N K, Latchaw R E, Lockman L A, Hasegawa D K, Coates T D, Coccia P F, Edson J R, Nesbit M E, Krivit W
Cancer. 1980 Oct 1;46(7):1548-54. doi: 10.1002/1097-0142(19801001)46:7<1548::aid-cncr2820460709>3.0.co;2-7.
Sudden cerebrovascular insults occurred during or immediately following remission induction therapy in 4 children with acute lymphoblastic leukemia. In 3, cerebral infarction was due to thrombosis. In the fourth, an intracerebral hematoma developed representing either frank hemorrhaging or a hemorrhagic infarction. None of the patients had central nervous system leukemia or extreme leukocytosis at the time of diagnosis. Symptoms were obtundation, hemiparesis, seizures, and headache. The induction chemotherapy included L-asparaginase which causes deficiencies of antithrombin, plasminogen, fibrinogen, and factors IX and XI. These hemostatic abnormalities may explain the thromboses and bleeding observed in these children.
