Cns Leukemia

CNS leukemia associated with AML is not very common, and CNS prophylaxis is not routine [unlike with acute lymphoblastic leukemia (ALL)].17 The incidence of meningeal disease has been reported to be as high as 15% in adults.418 It tends to occur more commonly with the monocytic and myelomonocytic subtypes and is associated with higher white blood counts, t(8;21), and the inv (16).412 Symptoms typically occur secondary to elevated intracranial pressure and include headache, blurred vision, and vomiting.12 Cranial nerve palsies, secondary to infiltration of cranial nerve roots, particularly abducens palsy leading to a lateral strabismus, may occur.12 Ophthalmologic examination may reveal retinal infiltration and/or papilledema.12 Cerebral masses are rare, but may occur in patients with M4eo and inv(16).4

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