LEUKAEMIC INVOLVEMENT OF CENTRAL NERVOUS SYSTEM

Area of Science:

• Neurology
• Hematology
• Oncology

Background:

• Leukemia, a cancer of blood-forming tissues, can affect the central nervous system (CNS).
• Clinical detection of CNS involvement in leukemia patients can be challenging.

Purpose of the Study:

• To evaluate the prevalence and spectrum of central nervous system (CNS) involvement in leukemia patients.
• To compare clinical findings with autopsy results for CNS lesions in leukemia.

Main Methods:

• Retrospective analysis of 82 leukemia patients (25 acute lymphocytic leukaemia, 38 acute myeloid leukaemia, 14 chronic myeloid leukaemia, 5 chronic lymphocytic leukaemia).
• Clinical neurological assessment for CNS involvement.
• Autopsy examination for CNS lesions.

Main Results:

• 23 (28.1%) patients had clinically detected neurological findings, including speech disorders, cranial nerve palsies, encephalopathy, ataxia, intracranial hemorrhage, peripheral neuropathy, and spinal cord involvement.
• Autopsy revealed CNS involvement in 45 (54.9%) patients.
• Prominent autopsy findings included leukaemic infiltrations (36.6%) and intracranial hemorrhage (26.8%), with additional findings of demyelination with astrocytosis (9.7%) and gliosis (2.4%).

Conclusions:

• A significant number of central nervous system (CNS) lesions in leukemia patients are clinically underestimated.
• Autopsy findings demonstrate a higher prevalence of CNS involvement than typically diagnosed during clinical evaluation.
• Improved diagnostic strategies are needed to detect CNS involvement in leukemia more effectively.