Association between cardiovascular risk factors and intracranial hemorrhage in patients with acute leukemia

Loes L Cornelissen, Aukje L Kreuger, Camila Caram-Deelder, Menno V Huisman, Rutger A Middelburg, Jean Louis H Kerkhoffs, Peter A von dem Borne, Erik A M Beckers, Karen M K de Vooght, Jürgen Kuball, Johanna G van der Bom, Jaap Jan Zwaginga*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


BACKGROUND: Intracranial hemorrhage is seen more frequently in acute leukemia patients compared to the general population. Besides leukemia-related risk factors, also risk factors that are present in the general population might contribute to hemorrhagic complications in leukemia patients. Of those, cardiovascular risk factors leading to chronic vascular damage could modulate the occurrence of intracranial hemorrhage in these patients, as during their disease and treatment acute endothelial damage occurs due to factors like thrombocytopenia and inflammation.

OBJECTIVES: Our aim was to explore if cardiovascular risk factors can predict intracranial hemorrhage in acute leukemia patients.

METHODS: In a case-control study nested in a cohort of acute leukemia patients, including 17 cases with intracranial hemorrhage and 55 matched control patients without intracranial hemorrhage, data on cardiovascular risk factors were collected for all patients. Analyses were performed via conditional logistic regression.

RESULTS: Pre-existing hypertension and ischemic heart disease in the medical history were associated with intracranial hemorrhage, with an incidence rate ratio of 12.9 (95% confidence interval [CI] 1.5 to 109.2) and 12.1 (95% CI 1.3 to110.7), respectively.

CONCLUSION: Both pre-existing hypertension and ischemic heart disease seem to be strong predictors of an increased risk for intracranial hemorrhage in leukemia patients.

Original languageEnglish
Pages (from-to)310-318
Number of pages9
JournalEuropean Journal of Haematology
Issue number4
Early online date19 Dec 2021
Publication statusPublished - Apr 2022


  • cardiovascular risk factors
  • intracranial hemorrhage
  • leukemia


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