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involvement of central nervous system in acute leukemia

Mervi Taskinen, Trausti Oskarsson, Mette Levinsen, Matteo Bottai, Marit Hellebostad, Olafur Gisli Jonsson, Päivi Lähteenmäki, Kjeld Schmiegelow, Mats Heyman
BACKGROUND: Central nervous system irradiation (CNS-RT) has played a central role in the cure of acute lymphoblastic leukemia (ALL), but due to the risk of long-term toxicity, it is now considered a less-favorable method of CNS-directed therapy. PROCEDURES: Retrospectively, we estimated the effect of CNS involvement and CNS-RT on events and overall survival (OS) in 835 children treated for high-risk ALL in the Nordic Society of Paediatric Haematology and Oncology (NOPHO) ALL-92 and ALL-2000 trials...
October 17, 2016: Pediatric Blood & Cancer
Sung-Soo Park, Jae-Ho Yoon, Hee-Je Kim, Young-Woo Jeon, Sung-Eun Lee, Byung-Sik Cho, Ki-Seong Eom, Yoo-Jin Kim, Seok Lee, Chang-Ki Min, Seok-Goo Cho, Dong-Wook Kim, Jong-Wook Lee, Woo-Sung Min
BACKGROUND: Acute myeloid leukemia (AML) with t(8;21)(q22;q22) is classified into a favorable-risk group. Extramedullary (EM) involvement has frequently been reported in this subgroup as resulting in a poor prognosis. However, characteristics or standard treatments of t(8;21) AML with EM involvement (EM-positive t(8;21)) have not yet been elucidated. PATIENTS AND METHODS: We retrospectively analyzed 154 adult AML patients with t(8;21). Among them, 17 were EM positive and 137 were EM negative at the time of diagnosis...
September 17, 2016: Clinical Lymphoma, Myeloma & Leukemia
Wangqiang Hu, Xiaoxia Wang, Rongrong Yang, Laixi Bi, Yaosheng Xie, Zhuo Zhang, Hong Lu, Lianfeng Wu
OBJECTIVE: To gain further insights into the predisposing risk factors for central nervous system (CNS) involvement in patients with acute lymphocytic leukemia (ALL), the impact of CD56 expression in these patients was investigated. METHODS: We reviewed the clinical features of CD56 expression in 588 consecutive ALL patients treated with systemic chemotherapy regimens between 2000 and 2014. The categorical data from CD56(+) ALL patients were compared with those from CD56(-) ALL patients...
October 13, 2016: Hematology (Amsterdam, Netherlands)
Khadega A Abuelgasim, Saeed Alshieban, Nada A Almubayi, Ayman Alhejazi, Abdulrahman R Jazieh
We describe the case of a young man with therapy-naive chronic myeloid leukemia who did not initially have any peripheral blood or bone marrow excess blasts but presented with extramedullary myeloid blast crises involving the central nervous system and multiple lymph nodes. Conventional cytogenetic tests were positive for t(9;22)(q34:q11) as well as for trisomy 8, 14 and 21 and del(16q). The patient's peripheral blood and bone marrow were positive for the BCR-ABL oncogene when analyzed by fluorescence in situ hybridization and polymerase chain reaction...
May 2016: Case Reports in Oncology
Ameera Alsadeq, Henning Fedders, Christian Vokuhl, Nele M Belau, Martin Zimmermann, Tim Wirbelauer, Steffi Spielberg, Michaela Vossen-Gajcy, Gunnar Cario, Martin Schrappe, Denis M Schewe
Central nervous system infiltration and relapse are poorly understood in childhood acute lymphoblastic leukemia. We examined the role of Zap-70 in preclinical models of central nervous system leukemia and performed correlative studies in patients. Zap-70 expression in acute lymphoblastic leukemia cells was modulated using short-hairpin ribonucleic acid-mediated knockdown or ectopic expression. We show that Zap-70 regulates CCR7/CXCR4 via activation of Erk. High expression of Zap-70 in acute lymphoblastic leukemia cells resulted in a higher proportion of central nervous system leukemia in xenografts as compared to Zap-70 low expressing counterparts...
September 29, 2016: Haematologica
Shyam A Patel
Acute myeloid leukemia (AML) involvement of the central nervous system is relatively rare, and detection of leptomeningeal disease typically occurs only after a patient presents with neurological symptoms. The case herein describes a 48-year-old man with relapsed/refractory AML of the mixed lineage leukemia rearrangement subtype, who presents with monocular vision loss due to leukemic eye infiltration. MRI revealed right optic nerve sheath enhancement and restricted diffusion concerning for nerve ischemia and infarct from hypercellularity...
2016: Case Reports in Hematology
María Facenda-Lorenzo, Ana Sánchez-Quintana, Alejandro Quijada-Fumero, Ana Laynez-Carnicero, Joaquín Breña-Atienza, Francisco J Poncela-Mireles, Juan M Llanos-Gómez, Ana I Cabello-Rodríguez, María Ramos-López
Secondary or metastatic cardiac tumors are much more common than primary benign or malignant cardiac tumors. Any tumor can cause myocardial or pericardial metastasis, although isolated or combined tumor invasion of the pericardium is more common. Types of neoplasia with the highest rates of cardiac or pericardial involvement are melanoma, lung cancer, and breast and mediastinal carcinomas. Acute myeloid leukemia (AML) is the most common type of acute leukemia in adults. Initial treatment involves chemotherapy followed by consolidation treatment to reduce the risk of relapse...
2016: Case Reports in Oncological Medicine
Jee Young Kim, Soo Ah Im, Ju Hyun Lee, Jae Wook Lee, Nak Gyun Chung, Bin Cho
BACKGROUND: Extramedullary relapse (EMR) is a recurrence of leukemia in sites other than the bone marrow, and it exhibits a relatively rare presentation of relapse of acute leukemia. However, EMR is an important cause of treatment failure among patients with acute leukemia. Therefore, early detection of these relapses may improve the prognosis. OBJECTIVES: To describe the disease-related demographic and clinical features and radiologic findings for children diagnosed with EMR in acute leukemia...
June 2016: Iranian Journal of Pediatrics
Susanna Ranta, Maarit Palomäki, Mette Levinsen, Mervi Taskinen, Jonas Abrahamsson, Karin Mellgren, Riitta Niinimäki, Kjeld Schmiegelow, Mats Heyman, Arja Harila-Saari
BACKGROUND: Each year approximately 200 children and adolescents are diagnosed with acute lymphoblastic leukemia (ALL) in the five Nordic countries, and 3% of these have central nervous system (CNS) involvement confirmed by leukemic cells in the cerebrospinal fluid (CSF) or neurological symptoms. We sought to determine the significance of neuraxis imaging in such patients. PROCEDURE: Magnetic resonance images of children aged 1-17.9 with CNS leukemia at diagnosis of ALL were centrally reviewed and clinical data were retrieved from the medical records and the Nordic leukemia registry...
August 24, 2016: Pediatric Blood & Cancer
K H Wu, H P Wu, H J Lin, C H Wang, H Y Chen, T Weng, C T Peng, Y H Chao
Hypopituitarism in leukemia is very rare. In addition, central nervous system (cns) relapse and leukemic retinopathy in childhood acute lymphoblastic leukemia (all) have declined with the use of modern systemic chemotherapy that includes cns prophylaxis. Here, we report the case of a 4-year-old girl who received chemotherapy and intrathecal therapy without cns radiation after a diagnosis of B-precursor all without cns involvement. Three months after chemotherapy completion, she presented with lower-extremity weakness and was diagnosed with an isolated cns relapse...
August 2016: Current Oncology
Sarah A Milgrom, Yago Nieto, Chelsea C Pinnix, Grace L Smith, Christine F Wogan, Gabriela Rondon, L Jeffrey Medeiros, Partow Kebriaei, Bouthaina S Dabaja
BACKGROUND: Patients who undergo allogeneic stem cell transplantation and subsequent radiation therapy uncommonly develop graft-versus-host disease within the irradiated area. We quantified the incidence of this complication, which is a novel contribution to the field. From 2010 to 2014, 1849 patients underwent allogeneic stem cell transplantation, and 41 (2 %) received radiation therapy afterward. Of these, two patients (5 %) developed graft-versus-host disease within the irradiated tissues during or immediately after radiation therapy...
2016: Journal of Medical Case Reports
Mette Levinsen, Hanne V Marquart, Line Groth-Pedersen, Jonas Abrahamsson, Birgitte K Albertsen, Mette K Andersen, Thomas L Frandsen, Arja Harila-Saari, Cornelis Pronk, Aina Ulvmoen, Goda Vaitkevičienė, Päivi M Lähteenmäki, Riitta Niinimäki, Mervi Taskinen, Maria Jeppesen, Kjeld Schmiegelow
BACKGROUND: Central nervous system (CNS) involvement is associated with relapse in childhood acute lymphoblastic leukemia (ALL) and is a diagnostic challenge. PROCEDURE: In a Nordic/Baltic prospective study, we assessed centralized flow cytometry (FCM) of locally fixed cerebrospinal fluid (CSF) samples versus local conventional cytospin-based cytology (CC) for detecting leukemic cells and evaluating kinetics of elimination of leukemic cells in CSF. RESULTS: Among 300 patients with newly diagnosed ALL, 87 (29%) had CSF involvement by FCM, while CC was positive in 30 (10%) of 299 patients with available CC data (P < 0...
November 2016: Pediatric Blood & Cancer
Seyed Ali Nabavizadeh, Joel Stein, Suyash Mohan
Leukemias are a heterogeneous group of hematologic malignancies that results from uncontrolled neoplastic proliferation of undifferentiated or partially differentiated hematopoietic cells. Patients with acute leukemia can have a variety of craniocerebral complications, which can result from direct leukemic involvement, secondary to cerebrovascular or infectious complications of leukemia, or can be treatment related. Imaging plays a central role in evaluating the central nervous system during treatment in patients with leukemia...
August 2016: Hematology/oncology Clinics of North America
Sarah K B Bick, Navid Redjal
Hematologic malignancies most commonly spread to the central nervous system via leptomeningeal infiltration. We present a unique case of a woman who presented with a right parietal mass as the initial manifestation of B cell acute lymphocytic leukemia. Because the diagnosis was unclear at the time of presentation she underwent surgical debulking of the mass prior to treatment with chemotherapy. Unfortunately, she relapsed several months after treatment and ultimately entered hospice care. We review the literature surrounding management considerations in patients with intracranial leukemic involvement...
July 15, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Kshitij Joshi, Harsha Panchal, Sonia Parikh, Gaurang Modi, Avinash Talele, Asha Anand, Urmila Uparkar, Nitin Joshi, Itesh Khatawani
The author describes paediatric case of relapsed acute lymphoblastic leukaemia (ALL) presented as aleukemic leukaemia cutis (ALC). A 2 year old child was admitted in tertiary oncology centre. He suffered from pre B cell ALL with absent Philadelphia chromosome. This patient received multiagent induction chemotherapy as per Berlin-Frankfurt-Munster (BFM) protocol for ALL. He achieved remission after 28 days of treatment. Subsequently he presented with multiple skin lesions in the form of multiple small erythematous violaceous macules, papules, plaques and nodules on face, chest and back regions...
June 2016: Indian Journal of Hematology & Blood Transfusion
Shiraj Sen, Arjun Gupta, Paul Friedman, Harris V Naina
Acute lymphoblastic leukemia (ALL) is a haematological malignancy that can involve the central nervous system (CNS). Less than 10 % of patients with ALL have CNS involvement at presentation. The cranial nerve most commonly affected is cranial nerve VII although bilateral involvement is rare. Management and outcomes of these patients are not well understood. Moreover bilateral Bells palsy as a presenting symptom of ALL is extremely uncommon. We report a very unusual presentation of ALL with bilateral facial nerve palsy, and discuss the management strategies and outcomes for patients with ALL that present with cranial nerve palsies...
June 2016: Indian Journal of Hematology & Blood Transfusion
Xiao Liu, Wei-Jing Li, Xiao-Xi Zhao, Chao Gao, Wei Zhao, Jin Jiang, Rui-Dong Zhang, Jing Xie, Hui-Wen Shi, Bin Wang, Yong-Hong Zhang, Xiao-Li Ma, Xuan Zhou, Min-Yuan Wu, Lei Cui, Zhi-Gang Li
OBJECTIVE: To investigate the clinical features, treatment and prognosis of children with SIL-TAL1 fusion gene positive T-cell acute lymphoblastic leukemia (T-ALL). METHODS: The data of 101 children with T-ALL were collected from April 2005 to November 2012 in Beijing Children's Hospital. The common clinical features, early treatment response, minimal residual disease (MRD), event-free survival (EFS) and relapse-free survival (RFS) were compared between children with SIL-TAL1 positive and negative T-ALL...
June 2016: Zhongguo Shi Yan Xue Ye Xue za Zhi
Amol Raheja, Aleksandra Sowder, Cheryl Palmer, Fausto J Rodriguez, William T Couldwell
Epstein-Barr virus (EBV)-associated smooth muscle tumors (SMTs) have recently been associated with primary and secondary immunodeficiencies. They are broadly divided into 3 subgroups: HIV-related, posttransplant, and congenital immunodeficiency. Subsequent to organ transplantation and acquired immunosuppression, a few cases of EBV-associated SMTs have been described in the liver, respiratory tract, and gastrointestinal system. To the authors' knowledge, intracranial involvement after peripheral blood stem cell transplantation has never been reported previously...
June 24, 2016: Journal of Neurosurgery
Ida M Ki Moore, Carrie J Merkle, Howard Byrne, Adam Ross, Ashley M Hawkins, Sara S Ameli, David W Montgomery
Central nervous system (CNS)-directed treatment for acute lymphoblastic leukemia, used to prevent disease recurrence in the brain, is essential for survival. Systemic and intrathecal methotrexate, commonly used for CNS-directed treatment, have been associated with cognitive problems during and after treatment. The cortex, hippocampus, and caudate putamen, important brain regions for learning and memory, may be involved in methotrexate-induced brain injury. Objectives of this study were to (1) quantify neuronal degeneration in selected regions of the cortex, hippocampus, and caudate putamen and (2) measure changes in the expression of genes with known roles in oxidant defense, apoptosis/inflammation, and protection from injury...
October 2016: Biological Research for Nursing
Marta Maschio, Francesco Marchesi, Sabrina Dispenza, Loredana Dinapoli, Francesca Sperati, Gianluca Petreri, Svitlana Gumenyuk, Maria Laura Dessanti, Alessia Zarabla, Tonino Cantelmi, Andrea Mengarelli
Background EEG activity is considered an index of functional state of brain. Chemotherapy (CT), used for non-central nervous system (CNS) cancer, can cross the blood brain barrier and contribute to changes in the functional state of brain that can alter background EEG activity. Quantitative EEG (qEEG) is superior to conventional EEG in the detection of subtle alterations of EEG background activity and for this reason, the use of qEEG might assist the clinician in evaluating the possible effect of CT on the CNS...
April 2016: Cognitive Neurodynamics
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