Pericarditis in patients with leukemia

Bierman, Howard R.; Perkins, Evan K.; Ortega, Paul

doi:10.1016/0002-8703(52)90084-7

Cited by 33 publications

(7 citation statements)

References 9 publications

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“…2 However, PEs have long been viewed as part of the leukemic disease process, arising secondary to hemorrhagic, infectious, or leukemic infiltrates. 3 PEs have also been thought to be associated with certain forms of chemotherapy including bleomycin, all-trans-retinoic acid, and cyclophosphamide. 4 PEs are a potentially life-threatening condition, especially if cardiac tamponade or constrictive pericarditis develops.…”

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confidence: 99%

Characteristics of pericardial effusions in patients with leukemia

Sampat

Rossi

García‐Gutiérrez

et al. 2010

Cancer

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Background Little information exists regarding the prevalence and natural history of pericardial disease in patients with leukemia. Recently, it has been reported that the use of histone deacytelase inhibitors (HDACi) is associated with an increased incidence of pericardial effusions (PEfs). To study the characteristics and treatment relationships of PEfs in patients with leukemia, we retrospectively analyzed a cohort of patients with leukemia evaluated at a single center. Methods We reviewed 2592 patients with acute myeloid leukemia (AML, N= 1282, 49%), acute lymphocytic leukemia (ALL, N= 336, 13%), or myelodysplastic syndrome (MDS, N=974, 38%), who were evaluated from 8/2003 to 7/2008. Electronic medical records were reviewed to select patients that had underwent at least one echocardiographic evaluation. Data regarding diagnosis, timing, effusion size, survival, and prior therapy was collected in the patients that had echocardiographic evidence of PEfs. Results PEfs were detected in 325 (20%) of the patients who had echocardiograms: 21% in AML, 23% in ALL, and 18% in MDS patients. Only a small portion of PEfs were detected prior to the initiation of therapy: 26% in AML, 25% ALL, and 15% in MDS. Most PEfs were of minimal size (70%) overall. No significant differences in effusion characteristics, including severity, were observed among different types of therapies. The presence of PEfs had no impact on the survival of patients evaluated. Conclusions PEfs are relatively common in patients with leukemia and do not appear to be related to specific types of therapy or to survival.

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confidence: 99%

Characteristics of pericardial effusions in patients with leukemia

Sampat

Rossi

García‐Gutiérrez

et al. 2010

Cancer

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“…Biopsy proof of EMH was, however, not obtained. In addition, tamponade in that patient followed progression of her disease to acute myelogenous leukemia, a condition which is more commonly associated with pericardial infiltration [5,6]. Our case may be unique in the biopsy documentation of life-threatening pericardial involvement prior to the emergence of a leukemic phase.…”

Section: Discussionmentioning

confidence: 78%

Pericardial tamponade associated with myeloid metaplasia

Bubley¹,

Come²,

MacDougall

et al. 1983

American J Hematol

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A 32-year-old white male with agnogenic myeloid metaplasia developed pericardial tamponade shortly after elective splenectomy. Tamponade was relieved by pericardiocentesis but recurred, necessitating partial pericardiectomy. Following surgery and a course of radiation therapy to the heart, there was no further significant reaccumulation of fluid. Pathologic evaluation demonstrated foci of extramedullary hematopoiesis in the pericardium. To our knowledge, pericardial tamponade has not previously been reported as a biopsy-proven complication of myeloid metaplasia.

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“…Although poorly understood, the pathophysiology behind the relationship between leukemia and acute pericardial disease is thought to be related to multiple factors including hemorrhage caused by concurrent thrombocytopenia, infections due to underlying immune deficiency, and direct malignant cell infiltration [ 7 , 8 ]. While the prognostic and therapeutic implications of malignant effusions in AML are not entirely known, it appears that an effusion large enough to cause tamponade increases mortality.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Tamponade as the Initial Presentation of Acute Myeloid Leukemia: A Case Report with Review of the Literature

Karmo

Hafeez

Halalau

et al. 2018

Case Reports in Oncological Medicine

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Acute myeloid leukemia (AML) is a complex disease with a variety of presentations. A large pericardial effusion is rare, occurring in less than 0.5% of all patients with AML prior to treatment. A 34-year-old male presented with dyspnea, malaise, and weight loss. On physical exam, he was noted to be hypoxic, tachypneic, tachycardic, and hypotensive. He had cervical lymphadenopathy and jugular venous distention. His WBC count was 110 bil/L with 33% blasts. Bone marrow biopsy confirmed AML with 60% blasts. Leukemic cells were also seen in the cerebrospinal fluid on lumbar puncture. An echocardiogram revealed a large pericardial effusion causing tamponade. He underwent emergent pericardiocentesis, and malignant cells were present in the pericardial fluid. Induction therapy with standard dose cytarabine and daunorubicin was initiated, and bone marrow biopsy 14 days later showed no residual AML. This case demonstrates the importance of a thorough evaluation of each organ system when caring for a patient with AML.

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Pericarditis in patients with leukemia

Cited by 33 publications

References 9 publications

Characteristics of pericardial effusions in patients with leukemia

Characteristics of pericardial effusions in patients with leukemia

Pericardial tamponade associated with myeloid metaplasia

Cardiac Tamponade as the Initial Presentation of Acute Myeloid Leukemia: A Case Report with Review of the Literature

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