Abstract:
:Three children with ALL having poor prognostic features developed clinical and laboratory evidence of disseminated intravascular coagulation (DIC). Two developed a bleeding diathesis associated temporally with a rapid drop in blast cell counts during induction therapy with L-asparaginase, prednisone, and vincristine. One of these children died of massive cerebral hemorrhage. The third patient developed episodes of superficial thrombophlebitis associated with relapses and rising blast cell counts which responded to chemotherapy and treatment with heparin. The unusual association of ALL with DIC and the fact that all 3 patients had multiple poor prognostic signs have led us to monitor carefully the coagulation system and withhold L-asparaginase in patients with massive disease until the white cell count and organomegaly have responded to prednisone and vincristine. The more common association of DIC with non-lymphocytic leukemia and recent reports of the presence of the Ph' chromosome in children with leukemia morphologically resembling ALL suggest that chromosomal evaluation be done in selected leukemic patients.
journal_name
Cancerjournal_title
Cancerauthors
Champion LA,Luddy RE,Schwartz ADdoi
10.1002/1097-0142(197804)41:4<1642::aid-cncr282041subject
Has Abstractpub_date
1978-04-01 00:00:00pages
1642-6issue
4eissn
0008-543Xissn
1097-0142journal_volume
41pub_type
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