CNS Involvement in a Patient with Chronic Myeloid Leukemia.
Marcus A HealeyDaniel J AllendorfUma BorateAnkit MadanPublished in: Case reports in hematology (2021)
Inspite of medication compliance, some chronic myeloid leukemia (CML) patients will relapse/progress into an accelerated phase or blast crisis. Central nervous system (CNS) involvement is a rare manifestation of such a relapse. Here, we report a case of 23-year-old female who was diagnosed with CML in the accelerated phase and subsequently treated with imatinib. She developed early relapse in her CNS, and her treatment was switched to dasatinib and intrathecal chemotherapy with cytarabine and methotrexate. Her CNS disease went into remission, and she underwent matched unrelated donor (MUD) hematopoietic stem cell transplant (HSCT). We discuss various mechanisms of treatment failure, importance of vigilance for symptoms and signs of treatment failure/relapse, indications for use of different tyrosine kinase inhibitors (TKIs), and management of blast crises in CML.
Keyphrases
- chronic myeloid leukemia
- blood brain barrier
- hematopoietic stem cell
- end stage renal disease
- healthcare
- public health
- chronic kidney disease
- newly diagnosed
- free survival
- systemic lupus erythematosus
- emergency department
- acute myeloid leukemia
- squamous cell carcinoma
- rheumatoid arthritis
- low dose
- combination therapy
- depressive symptoms
- locally advanced
- prognostic factors