Saikia T K, Dhabhar B, Iyer R S, Nanjangud G, Gopal R, Nair C N, Nadkarni K S, Ashokkumar M S, Dhond S R, Advani S H
Department of Medical Oncology, Tata Memorial Hospital, Parel, Bombay, India.
Am J Hematol. 1993 May;43(1):10-3. doi: 10.1002/ajh.2830430104.
Fifteen patients with lymphoid blast crisis of chronic myelogenous leukemia (LyBC-CML) and five patients with acute lymphoblastic leukemia converting to Philadelphia-positive (Ph+) chronic myeloid leukemia (ALL Ph + CML) were followed. Seven of 15 (46.7%) LyBC-CML patients developed meningeal leukemia within a median period of 6 months (range 2-11 months), while there was no medullary relapse. Five of these responded well to triple intrathecal therapy. In the ALL Ph + CML patients, in spite of central nervous system (CNS) prophylaxis with IT MTX and 18 Gy cranial radiation, two of five patients (40%) experienced meningeal leukemia, one isolated and the other with medullary relapse. The data confirm that LyBC-CML patients experience a high incidence of meningeal leukemia. The role of CNS prophylaxis is not very clear, but its use may delay development and reduce morbidity due to CNS disease.
