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Intracranial haemorrhage a strong mortality risk factor for kids with acute leukaemia

14 Oct 2019
Childhood cancer and leukaemia in Singapore

Despite being uncommon, intracranial haemorrhages (ICH) are typically fatal among children with acute leukaemia, a recent study has found.

Reviewing a hospital database, researchers accessed the data of 494 children with acute leukaemia (median age at diagnosis, 4.9 years; 58.7 percent male). Of these, 12 developed ICH over a median follow-up of 2.1 years, resulting in an incidence density rate of 6.2 per 1,000 person-years.

Most of the children who developed ICH suffered from multiple bleeding sites, and eight ICH patients had severe cerebral oedema, leading to rapid brain herniation. The haemorrhage also tended to develop during the induction period of chemotherapy. Three patients had deep grey nuclei bleeding. ICH developed within a median of 18 days after leukaemia diagnosis.

ICH emerged as a significant mortality risk factor. Median survival time was 24 days in those who developed the condition, as opposed to 4.0 years in those who did not. The resulting likelihood of death was more than three times higher (hazard ratio, 3.17, 95 percent CI, 1.63–6.19; p<0.01).

Multiple logistic regression analysis found that age (adjusted odds ratio [OR], 1.19, 95 percent CI, 1.02–1.40; p=0.02), white blood cell counts (adjusted OR, 1.0049, 1.002–1.0077; p=0.001) and lactate dehydrogenase concentration (adjusted OR, 1.0077, 1.0021–1.0133; p=0.01) were all significant risk factors for the development of ICH.

“We found that the incidence of ICH in our patients was much higher than that in the general paediatric population,” said researchers. “The mortality rate … was high, and most patients … died within a short period.”

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Most Read Articles
Pearl Toh, 31 Dec 2019
Adding the neuraminidase inhibitor oseltamivir to usual care speeds up recovery from influenza-like illness by a day compared with usual care alone, with even greater benefits seen in older, sicker patients with comorbidities, according to the ALIC4E study.
23 Dec 2019
At a Menarini-sponsored symposium held during the Asian Pacific Society Congress, renowned cardiologist Prof John Camm provided the latest evidence for chronic stable angina with or without concomitant diseases, with a special focus on the antianginal agent ranolazine and combination therapies. The event was chaired and moderated by Dr Dante Morales from the University of the Philippines College of Medicine.
12 Jan 2020
Testosterone treatment may slightly improve sexual functioning and quality of life in men without underlying organic causes of hypogonadism, but it offers little to no benefit for other common symptoms of ageing, according to a study. In addition, long-term efficacy and safety of this therapy remain unknown.
Stephen Padilla, 5 days ago
The Lancet Commission on Hypertension Group has recently released a position statement that contains a list of recommendations for the improvement of accuracy standards for devices that measure blood pressure (BP).