title: High incidence of meningeal leukemia in lymphoid blast crisis of chronic myelogenous leukemia.
abstract: Fifteen patients with lymphoid blast crisis of chronic myelogenous leukemia (LyBC-CML) and five patients with acute lymphoblastic leukemia converting to Philadelphia-positive (Ph+) chronic myeloid leukemia (ALL Ph + CML) were followed. Seven of 15 (46.7%) LyBC-CML patients developed meningeal leukemia within a median period of 6 months (range 2-11 months), while there was no medullary relapse. Five of these responded well to triple intrathecal therapy. In the ALL Ph + CML patients, in spite of central nervous system (CNS) prophylaxis with IT MTX and 18 Gy cranial radiation, two of five patients (40%) experienced meningeal leukemia, one isolated and the other with medullary relapse. The data confirm that LyBC-CML patients experience a high incidence of meningeal leukemia. The role of CNS prophylaxis is not very clear, but its use may delay development and reduce morbidity due to CNS disease.
authors.affiliation: Department of Medical Oncology, Tata Memorial Hospital, Parel, Bombay, India.
authors.forename: T K
authors.initials: TK
authors.lastname: Saikia
authors.forename: B
authors.initials: B
authors.lastname: Dhabhar
authors.forename: R S
authors.initials: RS
authors.lastname: Iyer
authors.forename: G
authors.initials: G
authors.lastname: Nanjangud
authors.forename: R
authors.initials: R
authors.lastname: Gopal
authors.forename: C N
authors.initials: CN
authors.lastname: Nair
authors.forename: K S
authors.initials: KS
authors.lastname: Nadkarni
authors.forename: M S
authors.initials: MS
authors.lastname: Ashokkumar
authors.forename: S R
authors.initials: SR
authors.lastname: Dhond
authors.forename: S H
authors.initials: SH
authors.lastname: Advani
mesh_terms: D001752:Blast Crisis / Q000401:mortality / Q000503:physiopathology*; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D015994:Incidence; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000401:mortality / Q000473:pathology* / Q000503:physiopathology*; D017254:Leukemic Infiltration / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control / Q000628:therapy; D008578:Meninges / Q000473:pathology*; D008727:Methotrexate / Q000627:therapeutic use; D015260:Neprilysin / Q000032:analysis; D011878:Radiotherapy / Q000379:methods; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D006684:HLA-DR Antigens; D015260:Neprilysin; D008727:Methotrexate