J Korean Pediatr Soc.  2001 Sep;44(9):1041-1046.

A Case of Vascular Leak Syndrome During Induction Chemotherapy of Acute Lymphoblastic Leukemia (T Cell Type)

• Kang KW
• Kim HM
• Choi WK
• Lim BK
• Lee CH

Abstract

Vascular leak syndrome(VLS) is characterized by endothelial damage, which causes extravasation of plasma proteins and fluid from capillaries into the extravascular space. It has been suggested that the increased vascular permeability is the result of an IL-2-induced suppression of endothelin-1 secretion by endothelial cells, an IL-2-induced activation of the complement cascade or TNF-alpha release from IL-2-activated T-cells. A 13-year-old male patient visited our hospital with abdominal pain. He was diagnosed with acute lymphoblastic leukemia(T cell type) by bone marrow study on his 2 nd day in hospital. On the 3 rd day of induction chemotherapy(prednisone, L-asparaginase, vincristine, intrathecal methotrexate), pulmonary edema and pleural effusion, ascites and generalized edema developed and lasted for 53 days without responding to supportive care. The laboratoy finding was that TNF-alpha was increased without evidence of infection and hypoalbuminemia was noted. It was suggested that the patient's clinical feature was induced by VLS.

Keyword

ALL; Vascular leak syndrome

MeSH Terms

Abdominal Pain
Adolescent
Ascites
Blood Proteins
Bone Marrow
Capillaries
Capillary Permeability
Complement System Proteins
Edema
Endothelial Cells
Endothelin-1
Humans
Hypoalbuminemia
Induction Chemotherapy*
Male
Pleural Effusion
Precursor Cell Lymphoblastic Leukemia-Lymphoma*
Pulmonary Edema
T-Lymphocytes
Tumor Necrosis Factor-alpha
Vincristine
Blood Proteins
Complement System Proteins
Endothelin-1
Tumor Necrosis Factor-alpha
Vincristine