All issues > Volume 44(9); 2001

Case Report

J Korean Pediatr Soc. 2001;44(9):1041-1046. Published online September 15, 2001.

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

Kye Wool KW Kang¹, Hwang Min HM Kim¹, Won Kyu WK Choi¹, Baek Keun BK Lim¹, Chang Hun CH Lee²

¹Department of Pediatrics, Wonju College of Medicine, Yonsei University, Wonju, Korea
²Department of Clinical Pathology, College of Medicine, Konkuk University, Chungju, Korea

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-αrelease 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-α was increased without evidence of infection and hypoalbuminemia was noted. It was suggested that the patient's clinical feature was induced by VLS.

Keywords :ALL, Vascular leak syndrome