Central Nervous System Relapse in a Patient with Acute Myeloid Leukemia Following Chemotherapy

Acute myeloid leukemia (AML) is a hematologic malignancy. It is the most common form of acute leukemia among adults. Recent treatment advances have drastically improved outcomes for these diseases, but the overall survival (OS) is still exceptionally low due to the infiltration of leukemic cells in the central nervous system (CNS).

Standard microscopic examination of cells in the cerebrospinal fluid (CSF), analysis of the chemical composition of the cerebrospinal fluid, and to integrate flow cytometry (FCM) to analyze the phenotypic characteristics of cells to find leukemia cells.

Pandy's test was positive in CSF, protein content was measured at 102.60 mg/dL, and leukemia cells were observed under microscopes. It was the gold standard for diagnosis. FCM also found 99.6% leukemia cells (CD33bri/CD13-/HLA-DR+/CD11c+/CD64dim/CD56+/CD117-/CD34-/CD38+/CD45dim/CD19-/CD15+/CD14-). The chromosomal karyotype also showed abnormalities.

Early detection of leukemia cells invading the central nervous system by routine examination in cytogenetic abnormalities, monocytic subtypes of AML patients, such as routine smear examination of CSF, has great clinical value for early detection, diagnosis, and intervention of patients with CNSL.