Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Turk J Med Sci. 2021 Oct 21;51(5):2351-2356. doi: 10.3906/sag-2103-127.
BACKGROUND/AIM: To evaluate the incidence, clinical features, risk factors, and prognosis of central nervous system (CNS) involvement in patients with acute myeloid leukemia (AML).
All AML patients who were admitted to Hacettepe University hospital between 2000 and 2021 were evaluated. The medical records of 548 AML cases were retrospectively analyzed.
The frequency of CNS involvement was 2.4% (n = 13) at diagnosis and 4.6% (n = 25) at diagnosis or during follow-up. Parenchymal involvement was seen in 5 patients, leptomeningeal involvement was seen in 11 patients. Three patients had both leptomeningeal and parenchymal involvements, and 6 patients had optic nerve or ocular involvement. In univariate analysis, younger age and extramedullary involvement at diagnosis were associated with CNS disease at diagnosis, and extramedullary involvement at diagnosis was associated with CNS disease during follow-up. In multivariate analysis; younger age and extramedullary involvement at diagnosis were associated with CNS disease at diagnosis and during follow-up respectively. Median overall survival was 5.4 months in patients with CNS disease at diagnosis and 16.9 months in patients with CNS disease during follow-up and 16.2 months in patients with no CNS disease.
CNS disease is a rare complication of AML. Younger age and extramedullary involvement at diagnosis are risk factors for CNS involvement.
背景/目的：评估急性髓系白血病（AML）患者中枢神经系统（CNS）受累的发生率、临床特征、危险因素和预后。
评估了 2000 年至 2021 年间在哈塞特佩大学医院就诊的所有 AML 患者。回顾性分析了 548 例 AML 病例的病历。
诊断时 CNS 受累的频率为 2.4%（n=13），诊断或随访时为 4.6%（n=25）。5 例患者有实质受累，11 例患者有软脑膜受累。3 例患者同时有软脑膜和实质受累，6 例患者有视神经或眼部受累。在单因素分析中，年龄较小和诊断时骨髓外受累与诊断时的 CNS 疾病相关，而诊断时的骨髓外受累与随访时的 CNS 疾病相关。在多因素分析中；年龄较小和诊断时骨髓外受累分别与诊断时和随访时的 CNS 疾病相关。诊断时有 CNS 疾病的患者中位总生存期为 5.4 个月，随访时有 CNS 疾病的患者为 16.9 个月，无 CNS 疾病的患者为 16.2 个月。
CNS 疾病是 AML 的罕见并发症。年龄较小和诊断时骨髓外受累是 CNS 受累的危险因素。
