Anticoagulation treatment and prophylactic edoxaban for cerebral sinus venous thrombosis in an adolescent with acute lymphoblastic leukemia. (April 2021)

• Record Type: Journal Article
• Authors: Koganesawa, Masaya; Matsuno, Ryosuke; Sugishita, Yumiko; Kaneko, Ryota; Kawabata, Naoko; Fujita, Sachio; Akiyama, Kosuke; Toyama, Daisuke; Yamamoto, Shohei
• Is Part Of: SAGE open medical case reports. Volume 9(2021)
• Publication Date: 2021-04
• Subjects: Acute lymphoblastic leukemia -- adolescent and young adults -- cerebral sinus venous thrombosis -- edoxaban -- L-asparaginase; Clinical medicine -- Case studies -- Periodicals; 616.09
• DOI: 10.1177/2050313X211013225
• Languages: English
• ISSNs: 2050-313X

Abstract

Pediatric acute lymphoblastic leukemia regimens include large L-asparaginase dosages and steroids, which are associated with an increased risk of venous thromboemboli in adolescents and young adults. Herein, we report the case of an 18-year-old male with acute lymphoblastic leukemia, who was treated with the pediatric regimen, in which edoxaban was employed as a prophylaxis against cerebral sinus venous thrombosis. The event happened on day 20 of induction therapy, when brain magnetic resonance imaging demonstrated a cerebral sinus venous thrombosis in the superior sagittal sinus. Anticoagulation therapy was initiated, and the patient's symptoms disappeared 3 days later. The induction therapy was restarted after an interruption of 16 days, and the consolidation therapies, which included L-asparaginase and steroids, were completed. Edoxaban was administered as a prophylaxis during the consolidation therapy. There were no further adverse events. Edoxaban could be an effective prophylaxis for coagulation complications in adolescents and young adults with acute lymphoblastic leukemia.