{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T17:08:46Z","timestamp":1790356126339,"version":"4.1.0"},"reference-count":15,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2011,8]]},"abstract":"\n Object<\/jats:title>\n Intracranial hemorrhage (ICH) is a frequent complication found in leukemia patients with thrombocytopenia. At the University of Texas MD Anderson Cancer Center, when a leukemia patient is found to have ICH, a platelet transfusion is generally recommended until 50,000\/\u03bcl is reached. The authors examine the feasibility and outcome of their intervention strategy in this study.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Records were reviewed from 76 consecutive leukemia patients with newly diagnosed ICH at the University of Texas MD Anderson Cancer Center from January 1, 2007, to December 31, 2009. Variables of interest included age, platelet count at presentation, leukemia subtype, history of trauma, Glasgow Coma Scale score at presentation, whether the 50,000\/\u03bcl goal was reached after transfusion, and whether the patient was a transfusion responder (platelet count increase > 2000\/\u03bcl\/unit transfused). Outcome parameters were mortality rates at 72 hours and 30 days and imaging-documented hemorrhage progression.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Thrombocytopenia was prevalent at the time of presentation (68 of 76 patients had platelet levels < 50,000\/\u03bcl at presentation). Despite an aggressive transfusion protocol, only 24 patients reached the 50,000\/\u03bcl target after an average of 16 units of transfusion. Death due to ICH occurred in 15 patients within the first 72 hours (mortality rate 19.7%). Death correlated with the presenting Glasgow Coma Scale score (p = 0.0075) but not with other transfusion-related parameters. A significant mortality rate was again observed after 30 days (32.7%). The 30-day mortality rate, however, was largely attributable to non-ICH related causes and correlated with patient age (p = 0.032) and whether the patient was a transfusion responder (p = 0.022). Reaching and maintaining a platelet count > 50,000\/\u03bcl did not positively correlate with the 30-day mortality rate (p = 0.392 and 0.475, respectively).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Platelet transfusion in the setting of ICH in leukemia patients is undoubtedly necessary, but whether the transfusion threshold should be 50,000\/\u03bcl remains unclear. Factors other than thrombocytopenia likely contribute to the overall poor prognosis.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2011.4.jns101784","type":"journal-article","created":{"date-parts":[[2011,5,13]],"date-time":"2011-05-13T10:19:18Z","timestamp":1305281958000},"page":"268-272","source":"Crossref","is-referenced-by-count":21,"title":["Clinical outcome of leukemia patients with intracranial hemorrhage"],"prefix":"10.3171","volume":"115","author":[{"given":"Joshua J.","family":"Chern","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Baylor College of Medicine, Houston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Tsung","sequence":"additional","affiliation":[{"name":"Illinois Neurological Institute, University of Illinois College of Medicine at Peoria, Illinois; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Humphries","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Baylor College of Medicine, Houston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Sawaya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Baylor College of Medicine, Houston, Texas;"},{"name":"The University of Texas MD Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick F.","family":"Lang","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns101784","series-title":"Semin Thromb Hemost","first-page":"380","article-title":"Use of platelets and other transfusion products in patients with malignancy","volume":"18","author":"Bayer","year":"1992"},{"key":"b2-jns101784","series-title":"Am J Hematol","first-page":"147","article-title":"Surgery in acute leukemia: a review of 167 operations in thrombocytopenic patients","volume":"26","author":"Bishop","year":"1987"},{"key":"b3-jns101784","series-title":"N Engl J Med","first-page":"905","article-title":"The quantitative relation between platelet count and hemorrhage in patients with acute leukemia","volume":"266","author":"Gaydos","year":"1962"},{"key":"b4-jns101784","series-title":"Lancet","first-page":"1223","article-title":"Safety of stringent prophylactic platelet transfusion policy for patients with acute leukaemia","volume":"338","author":"Gm\u00fcr","year":"1991"},{"key":"b5-jns101784","series-title":"J Stroke Cerebrovasc Dis","first-page":"204","article-title":"Clinical description of intracranial hemorrhage associated with bleeding disorders","volume":"17","author":"Gonz\u00e1lez-Duarte","year":"2008"},{"key":"b6-jns101784","series-title":"Medicine (Baltimore)","first-page":"16","article-title":"Cerebrovascular complications in patients with cancer","volume":"64","author":"Graus","year":"1985"},{"key":"b7-jns101784","series-title":"J Clin Oncol","first-page":"1143","article-title":"Randomized study of prophylactic platelet transfusion threshold during induction therapy for adult acute leukemia: 10,000\/microL versus 20,000\/microL","volume":"15","author":"Heckman","year":"1997"},{"key":"b8-jns101784","series-title":"Cancer","first-page":"1705","article-title":"The incidence and impact of thrombocytopenia in myelodysplastic syndromes","volume":"109","author":"Kantarjian","year":"2007"},{"key":"b9-jns101784","series-title":"Leukemia","first-page":"770","article-title":"Risk score model for fatal intracranial hemorrhage in acute leukemia","volume":"20","author":"Kim","year":"2006"},{"key":"b10-jns101784","series-title":"Br J Haematol","first-page":"609","article-title":"Consensus Conference on Platelet Transfusion, Royal College of Physicians of Edinburgh, 27\u201328 November 1997. 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