title: Prediction model for mortality after intracranial hemorrhage in patients with leukemia.
abstract: Intracranial hemorrhage (ICH) is associated with great morbidity and mortality in patients with acute leukemia. We identified 118 patients with ICH from a total of 2,421 patient with leukemia who were treated at our institution between 2005-2009, and assessed the prognostic factors for mortality in the ICH cohort. Median age at time of ICH was 58 years, 49% were male, and 60% had acute myeloid leukemia. The relative incidence of ICH was highest in patients with chronic myeloid leukemia in blast crisis (12.1%). Mental status changes were the most common symptom which prompted work-up for ICH. Median survival for all patients after onset of ICH was 20 days. In multivariate analyses, four clinical characteristics were identified as independent adverse factors for mortality in patients with ICH: albumin <3.5 g/dL, lactate dehydrogenase (LDH) >835 U/L, age > 60 years, and relapsed disease status. Based on the number of risk factors, mortality after ICH was: 25% (0 risk factor), 47% (1), 78% (2), and >97% (3 or 4). In conclusion, patients with leukemia who develop ICH do not have universally poor outcomes, and a simple scoring system could serve to advise physicians and families of the prognosis and the potential benefit of aggressive treatment options.
authors.affiliation: Division of Cancer Medicine, University of Texas, MD Anderson Cancer Center, Houston, USA.
authors.forename: Farshid
authors.initials: F
authors.lastname: Dayyani
authors.forename: Sarah Schellhorn
authors.initials: SS
authors.lastname: Mougalian
authors.forename: Kiran
authors.initials: K
authors.lastname: Naqvi
authors.forename: Jianqin
authors.initials: J
authors.lastname: Shan
authors.forename: Farhad
authors.initials: F
authors.lastname: Ravandi
authors.forename: Jorge
authors.initials: J
authors.lastname: Cortes
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Weinberg
authors.forename: Elias
authors.initials: E
authors.lastname: Jabbour
authors.forename: Stefan
authors.initials: S
authors.lastname: Faderl
authors.forename: William
authors.initials: W
authors.lastname: Wierda
authors.forename: Deborah
authors.initials: D
authors.lastname: Thomas
authors.forename: Susan
authors.initials: S
authors.lastname: O'Brien
authors.forename: Sherry
authors.initials: S
authors.lastname: Pierce
authors.forename: Hagop
authors.initials: H
authors.lastname: Kantarjian
authors.forename: Guillermo
authors.initials: G
authors.lastname: Garcia-Manero
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D020300:Intracranial Hemorrhages / Q000097:blood / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D007770:L-Lactate Dehydrogenase / Q000097:blood; D007938:Leukemia / Q000097:blood / Q000150:complications / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis
chemical_list: D012709:Serum Albumin; D007770:L-Lactate Dehydrogenase