Leukemia (CNS manifestations)

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

CNS manifestations directly attributed to leukemia

• leukemic meningitis
• intradural spinal involvement
• granulocytic sarcoma (chloroma)
• hematological and cerebrovascular complications
  • cerebral hemorrhage
    • most common in acute leukemia
    • disseminated intravascular coagulation: multiple microhemorrhages in the subcortical white matter
    • also due alterations in coagulation factors, thrombocytopenia and leukocytosis
  • dural venous sinus thrombosis
• CNS infections due to immunosuppression (e.g. CNS aspergillosis and neurocandidiasis)
• bone marrow infiltration: fat is replaced by leukemic elements
• ocular manifestations
  • retinal hemorrhage
  • leukemic infiltration of the optic nerve 

Leukemia treatment-related CNS complications

• chemotherapy
  • drug-induced PRES
  • 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

See also

• systemic involvement of leukemia 
  • thoracic manifestations 
  • testicular manifestations
  • musculoskeletal manifestations