Comparative Outcomes of Acute Ischemic Stroke With and Without Leukemia

By: Vansh Agrawal, Ardsley High School

Leukemia is a blood cancer that disrupts white blood cell production and can increase risks of infection, anemia, clotting, and stroke. However, there is limited large-scale research on how stroke treatment and outcomes differ in patients with leukemia. We analyzed National Inpatient Sample data from 2015–2022, including 3.8 million adult hospitalizations for acute ischemic stroke (AIS), of which 14,770 involved leukemia. After statistical weighting to balance demographics, we compared vascular risk factors, use of intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT), complications, and discharge outcomes. Compared with other AIS patients, those with leukemia were less likely to have traditional stroke risk factors such as hypertension, diabetes, or smoking history. They were also less likely to receive IVT or EVT, likely due to concerns about bleeding risk. Despite differences in risk profiles and lower use of reperfusion therapies, leukemia patients had similar in-hospital survival and were more often discharged home rather than to a nursing facility. These findings suggest leukemia-associated stroke requires individualized risk–benefit assessment and may benefit from tailored treatment strategies.