The Clinical Features and Treatment Outcomes of Intracranial Hemorrhage With Acute Leukemia and Disseminated Intravascular Coagulation

Abstract

Although intracranial hemorrhage (ICH)-complicating leukemia is life-threatening, its clinical features remain unclear due to the limited number of previous reports. In a retrospective study of 16 patients with hematological malignancy complicated by disseminated intravascular coagulation (DIC), including three patients with ICH, from 2018 to 2021 in Miyazaki Prefectural Miyazaki Hospital, we analyzed clinical features, laboratory markers, and treatment outcomes. The cumulative incidence of ICH was 18.7% and all patients presented with leukocytosis and DIC. Surprisingly, two patients died within a day due to ICH with brain herniation. One patient with ICH achieved complete remission. Notably, clinical markers showing higher leukocyte counts, higher LDH, higher FDP/d-dimer, higher HMGB-1, and poorer overall survival were identified in patients with leukemia with ICH. In conclusion, ICH should be considered a severe complication of hematological malignancies. Furthermore, the leukocyte count, and LDH and HMGB-1 levels may be related to leukemia with ICH.