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Leukemic infiltration of the cerebellum in acute myelomonocytic leukemia
Abstract:
A 31-year-old woman with acute myelomonocytic leukemia presented with meningeal signs and a cerebellar mass attributed to leukemic infiltration. The mass disappeared with radiation therapy and intraventricular chemotherapy, but the patient subsequently suffered several spinal nerve root recurrences, disseminated herpes zoster, and progressive multifocal leukoencephalopathy. At autopsy, there was no trace of the meningeal leukemia or cerebellar infiltrate. This case illustrates several of the neurologic complications of acute nonlymphocytic leukemia, and raises the question whether patients with the myelomonocytic form of this disease might benefit from prophylactic central nervous system treatment.
Insights
This case highlights neurological complications in acute myelomonocytic leukemia, including meningeal infiltration and cerebellar mass. It questions the need for prophylactic central nervous system treatment in these patients.
Area of Science:
- Hematology
- Neurology
- Oncology
Background:
- Acute myelomonocytic leukemia (AMML) is a subtype of acute nonlymphocytic leukemia.
- Neurological complications can arise in patients with acute myeloid leukemia.
Observation:
- A 31-year-old woman with AMML presented with meningeal signs and a cerebellar mass due to leukemic infiltration.
- Initial treatment with radiation and intraventricular chemotherapy resolved the cerebellar mass.
Findings:
- The patient experienced recurrent spinal nerve root issues, disseminated herpes zoster, and progressive multifocal leukoencephalopathy.
- Autopsy revealed no residual meningeal leukemia or cerebellar infiltration.
Implications:
- This case underscores the diverse neurologic complications associated with AMML.
- It suggests considering prophylactic central nervous system treatment for AMML patients to prevent such complications.