Cerebellar Infarction Following Remission Induction Therapy for Acute Lymphoblastic Leukemia

Abstract

A patient, 50-year-old female, developed cerebellar infarction following remission induction therapy for acute lymphoblastic leukemia. The therapy consisted of L-asparaginase, vincristine, aclarubicin and prednisolone. The concentration of protein C, antithrombin III, plasminogen and fibrinogen in the plasma taken from the patientb efore, during and after starting the chemotherapy were assayed retrospectively. Fibrinogen concentration rapidly decreased to 19% of its normal mean value on the day before developing cerebellar infarction. Protein C, antithrombin III and plasminogen also declined to 40%, 43%, and 35%, respectively, of their normal mean value.
The cerebellar infarction in the present case may be explained by this complex set of abnormalities in the coagulation and fibrinolytic system.