High incidence of meningeal leukemia in lymphoid blast crisis of chronic myelogenous leukemia.
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.
Saikia
T K
TK
Department of Medical Oncology, Tata Memorial Hospital, Parel, Bombay, India.
Dhabhar
B
B
Iyer
R S
RS
Nanjangud
G
G
Gopal
R
R
Nair
C N
CN
Nadkarni
K S
KS
Ashokkumar
M S
MS
Dhond
S R
SR
Advani
S H
SH
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
D006684:HLA-DR Antigens; D015260:Neprilysin; D008727:Methotrexate