Cerebromeningeal localizations in acute myeloblastic leukemia of the adult. Clinical and pathological study of 15 cases.
68 consecutive adults were treated for acute myeloblastic leukaemia (A.M.L). Involvement of the central nervous system (CNS) developed in 15 cases. The clinical characteristics of nine of these patients were: symptoms of increased intra-cranial pressure in 5, cranial nerve lesions in 4, peripheral nerve lesions in 5, cord compression in 1, hemispherical symptoms in 7. Lumbar puncture vas performed systematically on seven patients, two of them with evidence of meningeal leukaemia (M.L.). Post-mortem examination was performed on seven patients who died during the first induction treatment: three had evidence of C.N.S. involvement. M.L. developed in three patients during complete hematologic remission (R.C.) In patients younger than 60 years old, the incidence of M.L. was 8/24 (approximately 33%). Medial survival time was reduced:8 months in cases with M.L., compared to 13.5 months. Cerebro-fluid protein levels were increased in six cases without blast cells: in four cases, M.L. occurred within a few months. The frequency of meningeal leukaemia in A.M.I. is under-estimated. Eradication of this frequent complication is difficult. Prophylactic meningeal treatment may be instituted for patients younger than 60, to reduce the incidence of M.L. and to improve the median remission time.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000150:complications*; D002555:Cerebrospinal Fluid / Q000166:cytology; D005260:Female; D006801:Humans; D007938:Leukemia / Q000150:complications*; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D008297:Male; D008578:Meninges; D008875:Middle Aged; D013129:Spinal Puncture
Localisations cérébro-méningées des leucémies aiguës myéloblastiques de l'adulte. Etude clinique et anatomo-pathologique de 15 cas.