Leukemia (CNS manifestations)

Changed by Daniel J Bell, 26 Nov 2021

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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~~there is a proliferation of haematopoietic cells at an undifferentiated or partially differentiated stage of maturation.

CNS manifestations directly attributed to leukaemia

leukaemic meningitis
intradural spinal involvement
granulocytic sarcoma (chloroma)
haematological and cerebrovascular complications
- cerebral haemorrhage
  - most common in acute leukaemia ²
  - disseminated intravascular coagulation: multiple microhaemorrhages 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. <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>
+<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 there is 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/cns-infectious-diseases">CNS infections</a> due to <a title="Immunosuppression" href="/articles/immunosuppression">immunosuppression</a> (e.g. <a href="/articles/cns-aspergillosis">CNS aspergillosis</a> and <a href="/articles/neurocandidiasis">neurocandidiasis</a>)</li>
+<a href="/articles/cns-infectious-diseases">CNS infections</a> due to <a href="/articles/immunosuppression">immunosuppression</a> (e.g. <a href="/articles/cns-aspergillosis">CNS aspergillosis</a> and <a href="/articles/neurocandidiasis">neurocandidiasis</a>)</li>
-<li>radiation therapy<ul><li>radiation-induced neoplasms (e.g. <a href="/articles/radiation-induced-meningiomas-1">meningioma</a>, <a href="/articles/radiation-induced-glioma">glioma</a> and <a href="/articles/radiation-induced-sarcoma">sarcoma</a>)</li></ul>
+<li>
+<a title="Radiation therapy" href="/articles/radiotherapy-2">radiation therapy</a><ul><li>
+<a title="Radiation-induced carcinogenesis" href="/articles/radiation-induced-carcinogenesis">radiation-induced neoplasms</a> (e.g. <a href="/articles/radiation-induced-meningiomas-1">meningioma</a>, <a href="/articles/radiation-induced-glioma">glioma</a> and <a href="/articles/radiation-induced-sarcoma">sarcoma</a>)</li></ul>
~~-<li>bone marrow transplantation</li>~~
+<li><a title="Bone marrow transplantation" href="/articles/haematopoietic-stem-cell-transplantation">bone marrow transplantation</a></li>