Neoplastic meningitis in patients with acute myeloid leukemia scheduled for allogeneic hematopoietic stem cell transplantation.
We analyzed the frequency of neoplastic meningitis in patients with acute myeloid leukemia prior to allogeneic hematopoietic stem cell transplantation at our institution. Between 1996 and 2009, cerebrospinal fluid samples of 204 adult patients were examined during pre-transplant work-up for cell counts and, if abnormal, morphologically. We found blasts in cerebrospinal fluid samples of 17 patients with either persistent (n=9) or newly diagnosed (n=8) neoplastic meningitis. All patients proceeded to transplant. The proportion of patients with central nervous system involvement was significantly higher in patients with refractory disease at the time of transplantation compared with patients responding to prior systemic therapy (19% vs. 4.6%; P=0.003). Since most of the patients with central nervous system involvement were asymptomatic, cerebrospinal fluid evaluation should be considered at least in patients with refractory acute myeloid leukemia.
Bommer
Martin
M
Department of Internal Medicine III, University of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany. martin.bommer@uniklinik-ulm.de
von Harsdorf
Stephanie
S
Döhner
Hartmut
H
Bunjes
Donald
D
Ringhoffer
Mark
M
D000328:Adult; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000134:cerebrospinal fluid / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008577:Meningeal Neoplasms / Q000134:cerebrospinal fluid / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D008581:Meningitis / Q000134:cerebrospinal fluid / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D014184:Transplantation, Homologous