The incidence of central nervous system leukemia in adults with acute leukemia

Abstract

To determine the incidence of central nervous system leukemia (CNSL) in adults with acute leukemia (AL) we studied 299 patients admitted from 1966 to 1971, and reviewed 170 autopsies from that group. CNSL was diagnosed clinically in 38 of 299 (13%) patients, with a higher incidence in acute lymphocytic leukemia (ALL) and acute undifferentiated leukemia (AUL) and a lower incidence in acute myeloblastic leukemia (AML) and acute blastic crisis of chronic myelocytic leukemia (CML‐ABC). Autopsy evidence of CNSL was found in 43 of 170 (25%) evaluable autopsies with a higher incidence in ALL, AUL, and CML‐ABC, and a lower incidence in AML. The incidence of CNSL is related to morphological type, age, sex, survival, and responsiveness to chemotherapy. Arachnoidal infiltration was associated with a higher incidence of other pathologic manifestations of CNSL and extramedullary leukemic infiltrations. CNSL is common enough in adult AL to warrant aggressive diagnostic, therapeutic, and prophylactic measures.

Early central nervous system involvement in adults with acute non-myelogenous leukaemia

“…The difference was accounted for by the detection of asymptomatic disease by cerebro-spinal fluid (CSF) examination in the second study. A real increase in the incidence of CNS involvement in association with prolonged survival is suggested by Pavlovsky, Eppinger-Helft and Muriel (1973) and Wolk et al (1974 November 1972 andJune 1976 were treated with a standard protocol (OPAL). The diagnosis was established by examination of peripheral blood and bone marrow aspirate smears.…”

The central nervous system leukemia: a clinical and pathological study

“…This discrepancy might be attributed to a lower clinical suspiction of CNSL in CML si. There was no significant difference of CNSL for the two sexes as seen in other series 15,20,22,29,30 although some authors 25,31 have found a higher incidence in males. CNS involvement was found to occur throughout the course of the disease from early as two days after the clinical diagnosis of systemic leukemia to as late as 6 years.…”

Intracerebral leukemic mass in acute myelogenous leukemia

“…Clinically verified central nervous system (CNS) leukemia has been seen in about 6.5-17% of AML and 40-58% of ALL [2,8]. On autopsy study, 10-29% of AML [8--11] and 25-68% of ALL [9][10][11] cases showed CNS leukemia, but in most of the cases, there was diffuse leptomeningeal invasion, and microscopic parenchymal leukemic nodules were seen in only 7-12% [8,10]. On CT study, only 4-7.5% of leukemic patients were diagnosed as having intracranial mass in the course of their disease [12,13].…”

“…The number of cases with central nervous leukemia is increasing as more patients have good remission as a result of improvements in chemotherapy [2,8]. In the future, the incidence of CNS leukemia will likely be even higher so early diagnosis as well as prompt and adequate treatment will be essential in the management of these patients.…”