{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:12:31Z","timestamp":1753891951866,"version":"3.41.2"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T00:00:00Z","timestamp":1725926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The appearance of cerebral venous sinus thrombosis (CVST) in childhood acute lymphocytic leukemia (ALL) is a rare life-threatening disease that can cause significant morbidity, neurological sequelae, and potentially poor outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>We present the case of a 13-year-old boy with ALL who developed CVST and intrinsic hemorrhage approximately 30\u2005days after receiving chemotherapy with vincristine, dexamethasone, daunorubicin, and pegylated-asparaginase (PEG-Asp). He complained of a severe headache and then developed a generalized seizure at night. T1- and T2-weighted magnetic resonance imaging (MRI) and cerebral magnetic resonance venography sequences revealed superior sagittal sinus thrombosis and intrinsic hemorrhagic changes in the bilateral frontoparietal lobes. He received nadroparin calcium as the anticoagulant treatment and was switched to Erwinia asparaginase (Erwinia Asp) rather than PEG-Asp. Oxcarbazepine and clonazepam were started with good seizure control. Intrathecal treatment was delayed until 1\u2005month later. Anticoagulation treatment was stopped for 24\u2005h before and 6\u2005h after lumbar puncture. Platelet transfusion was administered to ensure the platelet count remained at &amp;gt;50\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L. Oral acetazolamide (500\u20131,000\u2005mg, daily) was administered to relieve headache and reduce intracranial pressure. Three months later, brain MRI showed a complete resolution of or significant improvement in the filling defect. Nadroparin calcium was administered for 1\u2005week after switching to Erwinia Asp to prevent clot recurrence. He completed the 6-month chemotherapy and is doing well with no neurological sequelae and no recurrence of bleeding or thrombosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Nadroparin calcium therapy appears to be safe and effective for pediatric CVST with ALL. The reintroduction of Erwinia Asp should be accompanied by anticoagulant therapy with nadroparin calcium<jats:bold>.<\/jats:bold><\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2024.1448445","type":"journal-article","created":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T04:37:09Z","timestamp":1725943029000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: A successful outcome of nadroparin calcium therapy for cerebral venous sinus thrombosis in a child with acute lymphoblastic leukemia"],"prefix":"10.3389","volume":"12","author":[{"given":"Lichun","family":"Xie","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ye","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guichi","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changgang","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lian","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feiqiu","family":"Wen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,9,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1080\/08880018.2022.2089791","article-title":"Incidence and risk factors of venous thromboembolism in childhood acute lymphoblastic leukaemia\u2014a population-based analysis of the Austrian Berlin-Frankfurt-M\u00fcnster (BFM) study group","volume":"40","author":"Gidl","year":"2023","journal-title":"Pediatr Hematol Oncol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e29581","DOI":"10.1002\/pbc.29581","article-title":"Predictors of thrombosis in children receiving therapy for acute lymphoblastic leukemia: results from Dana-Farber Cancer Institute ALL consortium trial 05-001","volume":"69","author":"Athale","year":"2022","journal-title":"Pediatr Blood Cancer"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2216","DOI":"10.1182\/blood-2006-04-015511","article-title":"Thrombotic complications in childhood acute lymphoblastic leukemia: a meta-analysis of 17 prospective studies comprising 1752 pediatric patients","volume":"108","author":"Caruso","year":"2006","journal-title":"Blood"},{"key":"B4","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1056\/NEJMra2106545","article-title":"Cerebral venous thrombosis","volume":"385","author":"Ropper","year":"2021","journal-title":"N Engl J Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e26694","DOI":"10.1002\/pbc.26694","article-title":"Cerebral sinus venous thrombosis during childhood acute lymphoblastic leukemia therapy: risk factors and management","volume":"64","author":"Ghanem","year":"2017","journal-title":"Pediatr Blood Cancer"},{"key":"B6","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1159\/000509802","article-title":"Cerebral venous thrombosis: a comprehensive review","volume":"83","author":"Idiculla","year":"2020","journal-title":"Eur Neurol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1161\/01.STR.0000206282.85610","article-title":"MRI of clot in cerebral venous thrombosis: high diagnostic value of susceptibility-weighted images","volume":"37","author":"Idbaih","year":"2006","journal-title":"Stroke"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1407","DOI":"10.1080\/10428190410001663671","article-title":"Enoxaparin can be used safely in patients with severe thrombocytopenia due to intensive chemotherapy regimens","volume":"45","author":"Herishanu","year":"2004","journal-title":"Leuk Lymphoma"},{"key":"B9","doi-asserted-by":"publisher","first-page":"764","DOI":"10.3760\/cma.j.cn112140-20200203-00058","article-title":"Acute lymphoblastic leukemia complicated with cerebral venous thrombosis in 14 children","volume":"58","author":"Liu","year":"2020","journal-title":"Zhonghua Er Ke Za Zhi"},{"key":"B10","doi-asserted-by":"publisher","first-page":"2459","DOI":"10.2217\/fon.15.114","article-title":"L-asparaginase and venous thromboembolism in acute lymphocytic leukemia","volume":"11","author":"Goyal","year":"2015","journal-title":"Future Oncol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"3285","DOI":"10.1182\/blood-2017-03-742304","article-title":"How I treat recurrent venous thromboembolism in patients receiving anticoagulant therapy","volume":"129","author":"Schulman","year":"2017","journal-title":"Blood"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e27","DOI":"10.1016\/S2352-3026(23)00314-9","article-title":"Apixaban versus no anticoagulation for the prevention of venous thromboembolism in children with newly diagnosed acute lymphoblastic leukaemia or lymphoma (PREVAPIX-ALL): a phase 3, open-label, randomised, controlled trial","volume":"11","author":"O'Brien","year":"2024","journal-title":"Lancet Haematol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.beha.2009.01.003","article-title":"Thrombosis in childhood acute lymphoblastic leukaemia: epidemiology, aetiology, diagnosis, prevention and treatment","volume":"22","author":"Nowak-G\u00f6ttl","year":"2009","journal-title":"Best Pract Res Clin Haematol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1791","DOI":"10.1056\/NEJMra042354","article-title":"Thrombosis of the cerebral veins and sinuses","volume":"352","author":"Stam","year":"2005","journal-title":"N Engl J Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1016\/j.nec.2010.03.006","article-title":"Cerebral venous sinus (sinovenous) thrombosis in children","volume":"21","author":"Dlamini","year":"2010","journal-title":"Neurosurg Clin N Am"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1448445\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,10]],"date-time":"2024-09-10T04:37:11Z","timestamp":1725943031000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2024.1448445\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,10]]},"references-count":15,"alternative-id":["10.3389\/fped.2024.1448445"],"URL":"https:\/\/doi.org\/10.3389\/fped.2024.1448445","relation":{},"ISSN":["2296-2360"],"issn-type":[{"type":"electronic","value":"2296-2360"}],"subject":[],"published":{"date-parts":[[2024,9,10]]},"article-number":"1448445"}}