Central nervous system involvement in adult acute leukemia

Abstract

Central nervous system (CNS) involvement was present in 16 of 59 (27%) adults with leukemia, i.e. in 13 of 40 (33%) with AML, of 3 (33%) with AMoL, and 2 of 8 (25%) with ALL. CNS leukemia was found at the time of diagnosis in 2 patients, during induction therapy in 2 patients, early in remission in 2 patients, during remission in patients, and at relapse in 4 patients. Fifteen of the 16 patients responded to intrathecal methotrexate, cytosine arabinoside or cranial irradiation. Only patients developed CNS relapse. CNS leukemia had no effect on survival. In 3 of 5 patients without CNS prophylaxis, the onset of neurologic manifestations was observed within one year of remission, whereas it was delayed for more than one year in all patients who had received prophylactic intrathecal methotrexate.