Aortic Valve Thrombus, Stroke, and Endovascular Thrombectomy in a Child With APML and Trisomy 21

J Pediatr Hematol Oncol. 2024 Jul 1;46(5):272-274. doi: 10.1097/MPH.0000000000002858. Epub 2024 Jun 5.

Abstract

APML, a subtype of acute myeloid leukemia, is highly curable, with cure rates over 90%. Despite its therapeutic success, APML poses elevated bleeding risks due to frequent prior disseminated intravascular coagulation. Less commonly recognized but critical is the thrombotic risk. We document a unique pediatric case: a 13-year-old with trisomy 21 diagnosed with APML had an asymptomatic aortic valve thrombus leading to thromboembolic arterial ischemic stroke. Through endovascular thrombectomy, cerebral circulation was re-established, extracting a fibrin thrombus with APML cells. Neurological recovery was swift. This report underscores the importance of vigilance for thrombotic complications in APML, highlighting the potential severity of overlooked risks.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Aortic Valve / pathology
  • Aortic Valve / surgery
  • Down Syndrome* / complications
  • Endovascular Procedures / methods
  • Female
  • Humans
  • Male
  • Stroke / etiology
  • Stroke / surgery
  • Thrombectomy* / methods
  • Thrombosis* / etiology
  • Thrombosis* / pathology