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Among the 19 patients,10 had two or more different CNS abnormalities found on CT scans or MR images.The imaging abnormalities seen in 12 patients during treatment included sinus thrombosis(n=3),transient gray or white matter ischeia(n=2),presumed dissemination microinfarcts(n=1),cerebral hemorrhage or infarct(n=3),inflammatory demyelinating polyradiculoneuropathy(n=1),infections(n=4,2 bacterial and 2 fungal),and meningeal leukemia(n=2).After therapy,seven patients had CNS imaging abnormalities,including secondary brain tumors(2 malignant gliomas and 1 CNS lymphoma),spinal chloroma(n=1),necrotizing leukoencephalopathy and mineralizing microangiopathy(n=3),cerebral mucormycosis(n=1),spontaneous intracranial hemorrhage(n=3),and spinal meningeal leukemia(n=1).The wide spectrum of CNS abnormalities that occur during and after treatment for leukemia is related to the inherent risk of the leukemia itself,to the treatment method,and to the duration of survival.Because many neurologic complications of leukemia are treatable,early diagnosis is essential. |
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