Recurrent Cerebral Venous Sinus Thrombosis Occurred in an Acute Lymphoblastic Leukemia Child with Mutated Lipoprotein Lipase Gene during Asparaginase Therapy

Abstract

Cerebral venous sinus thrombosis (CVST) and hyperlipidemia are severe complications of L-Asparaginase (L-Asp) during the treatment of B-cell acute lymphoblastic leukemia (B-ALL). Herein, we reported a 9-year-old B-ALL boy who underwent abnormal hypertriglyceridemia and CVST presenting as seizures and disturbance of consciousness twice during the induction therapy. Fortunately, he survived treatment with anticoagulant and lipid-lowering therapy. No thrombophilia-related gene mutation was detected, but a heterozygous mutation in lipoprotein lipase (LPL) gene was identified. His neurological symptoms were managed with short-term anticoagulant therapy and long-term lipid-lowering therapy. This case illustrated the manifestation and potential pathogenesis of CVST and highlighted the essentiality of screening baseline lipid profile and dyslipidemia- and thrombophilia-related gene mutation.

Keywords

acute lymphoblastic leukemia / gene mutation / L-Asparaginase / cerebral venous sinus thrombosis

Funding

This work was supported by the CAMS Innovation Fund for Medical Sciences (2022-I2M-1-022), the National Natural Science Foundation of China (82270144).

Conflict of Interest

None declared.

Acknowledgments

We thank the patients who participated in this trial and their families, and the staff of the National Clinical Research Center for Blood Diseases, Institute of Hematology and Blood Diseases Hospital.

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