• Jingrui Sui, Yongming Zhang, Liqing Yang, Hui Wang, Junqing Xu, Rongxia Wei, Yaping Hao, Xiaolei Wang, Jun Peng, and Junjie Ma.
• aDepartment of Hematology, Qilu Hospital, Shandong University, Jinan bDepartment of Hematology, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai cDepartment of Hepatobiliary Surgery, Yantaishan Hospital, Yantai dDepartment of Neurology, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai eDepartment of Endocrinology, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai, China.
• Medicine (Baltimore). 2017 Nov 1; 96 (46): e8715.

RationalePegaspargase has been used in the treatment of acute lymphoblastic leukemia with promising results. However, it has also been associated with several potentially serious complications, including thrombosis. Pegaspargase-induced cerebral venous thrombosis and bone marrow necrosis are very rare.Patient ConcernsA 50-year-old female developed headache, weakness of the right lower extremity, fever, and bone pain after chemotherapy including pegaspargase for the treatment of acute lymphoblastic leukemia.DiagnosesHer imaging studies and bone marrow examinations were compatible with cerebral venous thrombosis and bone marrow necrosis.InterventionsThe patient received anticoagulation therapy with rivaroxaban.OutcomesAfter treatment with rivaroxaban, she had a good outcome without major or minor bleeding.LessonsClinicians should be aware of the very rare but possible induction of bone marrow necrosis during pegaspargase treatment when there is necrosis in other organs. Because of its greater safety and convenience, rivaroxaban gains popularity over traditional anticoagulant drugs.

21 keywords...

hide…