A retrospective analysis of bleeding complications in 438 patients with acute leukaemia during the years 1972-1991.
The incidence and mortality of bleeding complications have been investigated in 438 patients with acute leukaemia consolidated either by chemotherapy (n = 241) or by bone marrow transplantation (n = 197). Bleeding signs on admission were found in 38% of the chemotherapy-treated group. Haemorrhagic deaths during the 1st month were seen in 10%. The majority of the major bleedings were localized intracranial, but gastrointestinal haemorrhages were also common. The platelet count was significantly lower (40 x 10(9)/l versus 69 x 10(9)/l, p < 0.001) and the leukocyte count significantly higher (31.2 x 10(9)/l versus 11.6 x 10(9)/l, p < 0.001) in the group with bleeding complications than in those without. The haemorrhagic mortality in patients consolidated with chemotherapy compared with transplant patients was similar, 23% and 19%. The majority of the lethal haemorrhages in the latter group were observed in patients undergoing allogenic bone marrow transplantation after engraftment. Septicaemia, graft-versus-host and venous occlusive disease were contributing factors.
Törnebohm
E
E
Dept. of Internal Medicine, Huddinge University Hospital, Sweden.
Lockner
D
D
Paul
C
C
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001803:Blood Transfusion; D016026:Bone Marrow Transplantation; D002648:Child; D003643:Death; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007938:Leukemia / Q000150:complications* / Q000401:mortality / Q000628:therapy; D015993:Life Tables; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
D000970:Antineoplastic Agents