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- Title
Thrombosis atrium in a patient with acute leukemia.
- Authors
Sakić, Meliha; Dinarević-Mesihović, Senka; Halimić, Mirza; Tunić, Adela; Hasanbegović, Edo; Mehadžić, Senada; Čengić, Nermana
- Abstract
Introduction: thrombosis is characterized by increased production of a clot in a blood vessel of the arteries, veins, capillaries or the cavities of the heart. The tendency of thrombosis is a result of predisposing factors that may be genetically determined, acquired, or both. Many acquired disorders are associated with specific pathological conditions such as, among others, malignant and myeloproliferative diseases. Acute leukemia is the most common malignancy in children. As part of the protocol for treatment of the disease, the L-asparaginase is used, and steroids which according to recent research are associated with the incidence of thrombosis. Epidemiology and pathogenesis of these entities are not yet clearly defined. Objective: to describe the case of a 6 years boy who developed thrombosis in the right atrium during the part of reinduction therapy for treatment of acute leukemia. Results: the boy was treated by scheme of the protocol ALL - BFM 2002. During the induction protocol, he received 6 cycles of L-ASP at a dose of 5000 IU/ m2, and in the stage 4 of reinduction cycle, L-ASP at a dose of 10000 ij/ m2. During both parts of the protocol, he was also treated with corticosteroids. By protocol algorithm for treatment of the underlying disease, the heart is regularly controlled by ultrasound. In the second part of the protocol reinduction, as part of the heart routine control, a large oval mass pro 32x20 mm was discovered attached to the lower wall of the right atrium and tricuspid stenosis seemed mild. PET - CT diagnostic finding of a thrombus in the right atrium was confirmed. Laboratory findings showed the following elevated values: CRP 77.4 / ref to 5 /; D-dimer were slightly increased 0.64 (ref <0.50). The other coagulation parameters, which were available in our laboratory, were within referenced values. The child was on anticoagulant alteplase therapy. After 17 days of therapy, thrombus decreased to one third. The oral anticoagulant therapy was continued. Conclusion: in all patients suffering from leukemia, besides regular laboratory findings it is necessary to make the heart ultrasound as well as coagulation factors and antithrombin III in the L-asparaginase implementation phase.
- Publication
Medical Journal / Medicinski Žurnal, 2015, Vol 21, Issue 3, p233
- ISSN
1512-5866
- Publication type
Academic Journal