背景:对于新诊断(从头)或新治疗的急性髓细胞性白血病(AML)并发血栓性并发症,尤其是动脉和静脉联合血栓形成。
方法:我们报道了一个13岁的男孩,被诊断患有AML和白细胞增多症,化疗期间发生右股静脉和右背动脉血栓形成。用低分子量肝素治疗后,Diosmin,和前列地尔,症状缓解。不幸的是,这个孩子后来患上了凝血病,这出乎意料地是由维生素K缺乏引起的。
结果:补充维生素K和凝血酶原复合物浓缩物后,凝血功能恢复。
结论:对于具有高血栓风险的儿童AML患者,抗凝治疗期间需要密切监测.同时,我们应该警惕过去的用药史和联合用药,尤其是那些可能导致维生素K缺乏的人,继发性出血,和凝血障碍。合理使用抗生素,抗凝剂,和抗肿瘤药物必须得到保证。
BACKGROUND: It is rare for newly diagnosed (de novo) or newly treated acute myeloid leukemia (AML) complicated with thrombotic complications, especially combined arterial and venous thrombosis.
METHODS: We reported a 13-year-old boy diagnosed with AML and leukocytosis, who developed right femoral vein and right dorsal artery thrombosis during chemotherapy. After treatment with low molecular weight heparin, diosmin, and alprostadil, symptoms were relieved. Unfortunately, the child suffered from coagulopathy afterward, which was unexpectedly caused by vitamin K deficiency.
RESULTS: After supplementation with vitamin K and prothrombin complex concentrate, coagulation function recovered.
CONCLUSIONS: For childhood AML patients with high thrombotic risks, close monitoring during anticoagulant treatment was necessary. Concomitantly, we should be alert to past medication history and combined medication use, especially those that may lead to vitamin K deficiency, secondary bleeding, and coagulation disorders. Rational use of antibiotics, anticoagulants, and antitumor drugs must be guaranteed.