Leukemia (CNS manifestations)

Changed by Bruno Di Muzio, 3 Mar 2019

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Leukaemia CNS manifestations can be divided into those related to the disease itself and those associated with its treatment. Leukaemias are haematologic malignancies in which occur a proliferation of haematopoietic cells at an undifferentiated or partially differentiated stage of maturation¹.

CNS manifestations directly attributed to leukaemia

leukaemic meningitis
intradural spinal involvement
granulocytic sarcoma (chloroma)
haematologic and cerebrovascular complications
- cerebral haemorrhage
  - most common in acute leukaemia ²
  - disseminated intravascular coagulation: multiple small haemorrhages in the subcortical white matter ¹
  - also due alterations in coagulation factors, thrombocytopenia, and leukocytosis ²
- dural venous sinus thrombosis
CNS infections due to immunosuppression (e.g. CNS aspergillosis and neurocandidiasis)
bone marrow infiltration: fat is replaced by leukaemic elements ³
ocular manifestations
- retinal haemorrhage
- leukaemic infiltration of the optic nerve ⁴

Leukaemia treatment-related CNS complications

chemotherapy
- drug-induced PRES ¹
- methotrexate neurotoxicity
  - aseptic meningitis
  - transverse myelopathy
  - stroke-like syndrome
  - demyelination and leukoencephalopathy
- CNS infections due to immunosuppression (e.g. CNS aspergillosis and neurocandidiasis)
radiation therapy
- radiation-induced neoplasms (e.g. meningioma, glioma and sarcoma)
bone marrow transplantation

-<p><strong>Leukaemia CNS manifestations</strong> can be divided into those related to the disease itself and those associated with its treatment. Leukaemias are haematologic malignancies in which occur a proliferation of haematopoietic cells at an undifferentiated or partially differentiated stage of maturation <sup>1</sup>.</p><h6>CNS manifestations directly attributed to leukaemia</h6><ul>
+<p><strong>Leukaemia CNS manifestations</strong> can be divided into those related to the disease itself and those associated with its treatment. <a href="/articles/leukaemia">Leukaemias</a> are haematologic malignancies in which occur a proliferation of haematopoietic cells at an undifferentiated or partially differentiated stage of maturation.</p><h6>CNS manifestations directly attributed to leukaemia</h6><ul>
~~-<a href="/articles/granulocytic-sarcoma">granulocytic sarcoma</a> (chloroma)</li>~~
+<a href="/articles/myeloid-sarcoma-1">granulocytic sarcoma</a> (chloroma)</li>
~~-<li>disseminated intravascular coagulation: multiple small haemorrhages in subcortical white matter <sup>1</sup>~~
+<li>disseminated intravascular coagulation: multiple small haemorrhages in the subcortical white matter <sup>1</sup>
~~-<a href="/articles/cns-infectious-diseases">CNS infections</a> due immunosuppression (e.g. CNS aspergillosis and neurocandidiasis)</li>~~
+<a href="/articles/cns-infectious-diseases">CNS infections</a> due to immunosuppression (e.g. CNS aspergillosis and neurocandidiasis)</li>
~~-<li>leukaemic infiltration of the <a title="Optic nerve" href="/articles/optic-nerve">optic nerve</a> <sup>4</sup>~~
+<li>leukaemic infiltration of the <a href="/articles/optic-nerve">optic nerve</a> <sup>4</sup>