Thrombosis of the sinus durae matris as a complication of therapy in patients with Hodgkin lymphoma


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Abstract

AIM. To describe thrombosis of the sinus durae matris (TSDM) in lymphomas. MATERIALS AND METHODS. 402 patients with Hodgkin lymphoma were treated using the ВЕАСОРР-14 protocol in 2006 to 2013. Thrombotic events occurred in 6% of the patients, including 3 (0.8%) who developed brain magnetic resonance imaging-verified TSDM. RESULTS. TSDM developed in 3 women aged 17, 18, and 25 years during 3-6 chemotherapy cycles involving glucocorticosteroids in a dose of 80 mg/m2 on days 1-7 and an oral contraceptive used continuously for 1.5-3 months. The symptoms of thrombosis were severe headache; 2 patients had convulsive syndrome with short-term loss of consciousness. Anticoagulant therapy with intravenous heparin 20,000-24,000 U/day led to thrombus recanalization within 4-10 days. No rethromoboses were observed during a subsequent follow-up. CONCLUSION. The ВЕАСОРР-14 treatment in young women with Hodgkin lymphoma who continuously take oral contraceptives should be combined with anticoagulant therapy, by monitoring their coagulogram.

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Тромбоз синусов твердой мозговой оболочки как осложнение терапии у больных лимфомой Ходжкина. - Резюме. Цель исследования. Описание тромбоза синусов твердой мозговой оболочки (ТСТМО) при лимфомах. Материалы и методы. С 2006 по 2013 г. терапия по программе ВЕАСОРР-14 проведена 402 больным лимфомой Ходжкина. Тромботические осложнения возникли у 6% пациентов, в том числе у 3 (0,8%) развился ТСТМО, подтвержденный данными магнитно-резонансной томографии головного мозга. Результаты. ТСТМО развился у 3 женщин в возрасте 17, 18 и 25 лет в период проведения 3-6-го курса химиотерапии, включавшего прием глюкокортикостероидов в дозе 80 мг/м2 в 1-7-й день и перорального контрацептивного средства в непрерывном режиме в течение 1,5-3 мес. Симптомами тромбоза были интенсивная головная боль, у 2 пациенток - судорожный синдром с кратковременной потерей сознания. Антикоагулянтная терапии гепарином в дозе 20-24 тыс. ЕД/сут внутривенно привела к реканализации тромба в течение 4-10 дней. При последующем наблюдении повторных тромбозов не отмечено. Заключение. Лечение молодых женщин с лимфомой Ходжкина по программе ВЕАСОРР-14, постоянно получающих пероральные контрацептивные средства, необходимо сопровождать антикоагулянтной терапией с мониторированием коагулограммы.
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References

  1. Caruso V., Di Castelnuovo A., Meschengieser S. et al. Thrombotic complications in adult patients with lymphoma: a meta-analysis of 29 independent cohorts including 18 018 patients and 1149 events. Blood 2010; 115 (26): 5322-5328.
  2. Cantwell B.M., Carmichael J., Ghani S.E., Harris A.L. Thromboses and thromboemboli in patients with lymphoma during cytotoxic chemotherapy. BMJ 1988; 297 (6642): 179-180.
  3. Sorensen H., Mellemkjaer L., Olsen J., Baron J. Prognosis of cancers associated with venous thromboembolism. N Engl J Med 343 (25): 1846-1850.
  4. Zhou X., Teegala S., Huen A. et al. Incidence and Risk Factors of Venous Thromboembolic Events in Lymphoma. Am J Med 2010; 123: 935-941.
  5. Ferro J. M., Canhão P., Stam J. Prognosis of Cerebral Vein and Dural Sinus Thrombosis. Results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT). Stroke 2004; 35: 664-670.
  6. Saposnik G., Barinagarrementeria F., Brown R.D. Jr et al. Diagnosis and management of cerebral venous thrombosis: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2011; 42 (4): 1158-1192.
  7. Mohren M., Markmann I., Jentsch-Ullrich K. et al. Increased risk of thromboembolism in patients with malignant lymphoma: a single-centre analysis. Br J Cancer 2005; 92 (8): 1349-1351.
  8. Чучин М.Ю. Церебральный синус-тромбоз в детском возрасте. Педиатрия 2005; 2: 63-70.
  9. Wada H., Sase T., Yamaguchi M. Hypercoagulant states in malignant lymphoma. Exp Oncol 2005 27 (3): 179-185.
  10. Vincristine Sulfate and Cerebral Venous Thrombosis. FDA Adverse Event Reporting System 2014.
  11. Békési B. Cerebral sinovenous thrombosis in children with Hodgkin's lymphoma. Доступно на http://www.aaf-online.org/php/member_area/onlinecases/index.php?act=view&id=292
  12. Stolz E., Klötzsch C., Schlachetzki F., Rahimi A. High-dose corticosteroid treatment is associated with an increased risk of developing cerebral venous thrombosis. Eur Neurol 2003; 49: 247-248.
  13. Gazioglu S., Solmaz D., Boz C. Cerebral venous thrombosis after high dose steroid in multiple sclerosis: a case report. Hippokratia 2013; 17 (1): 88-90.
  14. Smith A.G., Cornblath W.T., Deveikis J.P. Local thrombolytic therapy in deep cerebral venous thrombosis. Neurology 1997; 48 (6): 1613-16139.
  15. Ferro J.M., Crassard I., Coutinho J.M., Canhão P. et al. Decompressive surgery in cerebrovenous thrombosis: a multicenter registry and a systematic review of individual patient data. Stroke 2011; 42 (10): 2825-2831.
  16. Selim M. Cerebral Venous Thrombosis. Another Heparin Controversy. Stroke 2014; 45: 8-9.
  17. Cundiff D.K. Anticoagulants for Cerebral Venous Thrombosis: Harmful to Patients? Stroke 2014; 45: 298-304.
  18. Einhäupl K., Stam J., M.-G. Bousser et al. EFNS guideline on the treatment of cerebral venous and sinus thrombosis in adult patients. Eur J Neurol 2010; 17: 1229-1212.

Copyright (c) 2014 Shitareva I.V., Moiseeva T.N., Al'-Radi L.S., Margolin O.V., Khlavno A.B., Iatsyk G.A., Kravchenko S.K.

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