ArticleJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2023
Safety of intravenous thrombolysis for ischemic stroke in patients with hematologic malignancies: A single institution experience.
Article in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 4 citations in OpenAlex.
- Atrial fibrillation and ischemic stroke in cancer: the latest scientific evidence, current management, and future directions.Journal of thrombosis and thrombolysis · 2025Review
- Cerebrovascular and Peripheral Vascular Complications in Cancer Patients.Current neurology and neuroscience reports · 2025Review
- Prediction of hemorrhagic transformation after thrombolysis based on machine learning models combined with platelet distribution width-to-count ratio.Frontiers in neurology · 2025Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundData on safety of thrombolysis for acute ischemic stroke (AIS) in patients with hematologic malignancy is not well established. We report our single institution experience with thrombolysis in this patient population.
methodsWe identified patients with pathology-confirmed hematologic malignancy from 2000-2022. Primary exposure was presence of AIS and receipt of intravenous (IV) thrombolysis. Primary outcome was safety of IV thrombolysis in this patient population. Safety was measured through imaging review for hemorrhagic transformation, post-stroke mortality, and modified Rankin Scale (mRS) at 90 days.
resultsAmong 45,894 patients with hematologic malignancy, 1,099 (2.4%) were identified as having a suspected AIS. Twenty (1.8%) received IV tissue plasminogen activator (tPA) for AIS, three underwent endovascular intervention, and 17 had AIS confirmed on MRI. Two patients with confirmed AIS experienced hemorrhagic transformation, one of which was symptomatic. Most patients (n=10, 59%) were functionally independent (mRS 0-2) at 90 days post-stroke, including all patients with active hematologic malignancy at the time of stroke (n=3). Four patients died within 90 days of AIS. None of these deaths were patients with active hematologic malignancy at the time of stroke.
conclusionsWithout other contraindications, IV alteplase should be considered for management of AIS in patients with hematologic malignancy. The safety profile of tPA administration in this patient population may be similar to the general population, whether underlying hematologic malignancy is active or in remission.
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