Clinical commentaryRisk factors and clinical characteristics of non-promyelocytic acute myeloid leukemia of intracerebral hemorrhage: A single center study in China

- As a devastating disease, intracerebral hemorrhage (ICH) has high rates rate of mortality and morbidity. Approximately 10%-23% of strokes are caused by the rupture of cerebral blood vessels and the overall ICH incidence worldwide is 24.6 per 100,000 person-years. ICH is a common complication of cancer. As shown by recent studies, the risk of ICH is quite high in cancer patients [6], indicating that cancer itself can directly or indirectly cause the development of cerebral hemorrhage.
- In general, ICH is resulted from cancer-related coagulation disorders. Notably, ICH in various hematological malignancies in the clinical manifestations of the relative research is relatively limited. This study was designed to explore the risk factors and clinical characteristics of ICH of non-promyelocytic acute myeloid leukemia (AML). We retrospectively reviewed the medical records of patients admitted to the First Hospital of Zhejiang University from 2010 to 2015, and then examined the relationships among likely causes, age, gender, laboratory examination, past medical history, and habits.

BackgroundAlthough high mortality in patients with acute leukemia (AL) is associated with intracranial hemorrhage (ICH), the clinical features and pathogenesis of AL patients with cerebral hemorrhage are not well known.MethodsWe diagnosed 90 patients with ICH from a total of 1467 patients with non-promyelocytic AL who had been hospitalized in the First Affiliated Hospital of Medical School of Zhejiang University from January 2010 to October 2015. Moreover, the risk factors of ICH death were evaluated.ResultMedian age at ICH was 51 years old, in which men accounted for 52.2%. They also accounted for 85.6% of acute myeloid leukemia. The relative incidence of ICH was the highest in M2 and M5 (60.1%). ICH presented with higher peripheral blood white blood cell count (WBC) (P < 0.001), lower peripheral platelet counts (P < 0.001), lower albumin (P < 0.001), lower fibrous protein (P < 0.001) and prolongation of prothrombin time (P < 0.001) compared to those observed in the patients of NICH group; multivariate analysis, independent risk factors for death in patients with ICH include: WBC ≥ 30.00 × 109/l and prothrombin time ≥ 12.91 s.ConclusionsLeukocytosis and coagulation dysfunctions might be the main pathogenesis of acute leukemia complicated with cerebral hemorrhage.