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Treatment Induced Cerebral Sinus Venous Thrombosis in Childhood Acute Lymphoblastic Leukemia: New Risk Factors to Consider
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  • Habib El-Khoury,
  • Omran Saifi,
  • Mohamad Chahrour,
  • Salame Haddad,
  • Khaled Ghanem,
  • Yaacoub Mubarak,
  • Hani Tamim,
  • Cyril Zakka,
  • Anthony Chan,
  • Rami Mahfouz,
  • Nidale Tarek,
  • Hassan El-Solh,
  • Miguel Abboud,
  • Raya Saab,
  • Samar Muwakkit
Habib El-Khoury
American University of Beirut Faculty of Medicine
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Omran Saifi
American University of Beirut Faculty of Medicine
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Mohamad Chahrour
American University of Beirut Faculty of Medicine
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Salame Haddad
American University of Beirut Faculty of Medicine
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Khaled Ghanem
Basma Pediatric Oncology Unit
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Yaacoub Mubarak
Children's Cancer Center of Lebanon
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Hani Tamim
American University of Beirut
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Cyril Zakka
American University of Beirut Faculty of Medicine
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Anthony Chan
McMaster University
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Rami Mahfouz
American University of Beirut Medical Center
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Nidale Tarek
Children\'s Cancer Center of Lebanon
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Hassan El-Solh
King Faisal Specialist Hospital and Research Centre - Jeddah
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Miguel Abboud
Children's Cancer Center of Lebanon
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Raya Saab
American University of Beirut Medical Center
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Samar Muwakkit
Children's Cancer Center of Lebanon
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Abstract

Background: Cerebral Sinus Venous Thrombosis (CSVT) is one of many side effects encountered during acute lymphoblastic leukemia (ALL) therapy. Due to the rarity of cases, lack of data, consensus management, no recommendations exist to target the population at risk. Methods: This is a retrospective chart review of 229 consecutive patients diagnosed with ALL and aged 1–21 years, treated at the Children’s Cancer Institute (CCI) between October 2007 and February 2017. Results: The incidence of CSVT was 10.5%. Using univariate analysis, increased risk of CSVT was observed with male gender, age >10 years, T-cell immunophenotype, intermediate/high risk disease, maximum Triglyceride (TG) level of > 615 mg/dL, presence of mediastinal mass, and larger body surface area. With multivariate analysis, the only statistically significant risk factors were maximum TG level, body surface area (BSA), presence of mediastinal mass, and risk stratification (intermediate/high risk). Conclusion: Our study was able to unveil TG level of > 615 mg/dL, mediastinal mass, and a larger body surface area as novel risk factors that have not been previously discussed in the literature.

Peer review status:ACCEPTED

01 Feb 2021Submitted to Pediatric Blood & Cancer
01 Feb 2021Submission Checks Completed
01 Feb 2021Assigned to Editor
02 Feb 2021Reviewer(s) Assigned
28 Feb 2021Review(s) Completed, Editorial Evaluation Pending
28 Feb 2021Editorial Decision: Revise Minor
17 May 2021Submission Checks Completed
17 May 2021Assigned to Editor
17 May 20211st Revision Received
19 May 2021Reviewer(s) Assigned
02 Jun 2021Review(s) Completed, Editorial Evaluation Pending
04 Jun 2021Editorial Decision: Accept