Isolated central nervous system relapse in chronic myeloid leukemia.

Juliana Gomez,Victor Duenas

doi:10.1155/2015/232915

Abstract

Chronic myeloid leukemia is a myeloproliferative disorder that has three distinguished phases: chronic, accelerated, and blastic. In extremely rare cases, the blast phase can affect the central nervous system without concomitant bone marrow involvement. We report the case of a patient with chronic myeloid leukemia who, despite having achieved complete cytogenetic remission in the bone marrow for several years, experienced a blast crisis of the central nervous system following an episode of infectious meningoencephalitis.

Highlights

Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by the presence of a reciprocal translocation between chromosomes 9 and 22, known as the Philadelphia chromosome, which results in expression of an oncoprotein, termed BCR-ABL [1, 2]
Chronic myeloid leukemia is a myeloproliferative neoplasm with an incidence of one-two cases per 100 000 adults and accounts for 15% of newly diagnosed cases of leukemia in adults in the USA [7]
About 30 to 50% of CML patients are asymptomatic at diagnosis, in whom the disease is found on routine physical examination or blood tests

Summary

Introduction

Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by the presence of a reciprocal translocation between chromosomes 9 and 22, known as the Philadelphia chromosome, which results in expression of an oncoprotein, termed BCR-ABL [1, 2]. Blast phase (BP) or blast crisis is defined as the presence of 20% or more blasts in peripheral blood or bone marrow (BM), or a large focus of blasts in BM, or an extramedullary blast proliferation [4]. The central nervous system as a site of extramedullary blast crisis is extremely rare [5], and when affected it usually occurs concurrently with systemic relapse [6]. We here describe the case of a patient with chronic myeloid leukemia who, after an episode of infectious meningoencephalitis, experienced blast crisis of the central nervous system having achieved complete cytogenetic remission in the bone marrow for several years with imatinib treatment

Case Presentation

Findings

Discussion