Childhood leukemia: Central nervous system abnormalities during and after treatment

Cheng Yu Chen, Robert A. Zimmerman, Scott Faro, Larissa T. Bilaniuk, Ting Ywan Chou, Patricia T. Molloy

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

PURPOSE: To document the radiologic abnormalities seen in the central nervous system (CNS) during and after treatment of childhood leukemia. METHODS: MR images (19 patients) and CT scans (12 patients) were reviewed retrospectively in 19 children and adolescents with neurologic complications of leukemia or its treatment. Patients were divided into two groups: the first included those with disease related complications of leukemia, such as meningeal and parenchymal leukemia, chloroma, and cerebrovascular disorders; the second included patients with treatment-related neurotoxicity and infection caused by immunocompromised states. Pathologic confirmation of the CNS lesions was obtained in eight patients. Factors that predisposed to the development of tumor related or treatment related complications were determined by reviewing the medical records. RESULTS: 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 ischemia (n = 2), presumed disseminated 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). CONCLUSION: 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.

Original languageEnglish
Pages (from-to)295-310
Number of pages16
JournalAmerican Journal of Neuroradiology
Volume17
Issue number2
Publication statusPublished - 1996
Externally publishedYes

Fingerprint

Nervous System Malformations
Leukemia
Central Nervous System
Myeloid Sarcoma
Therapeutics
Nervous System
Polyradiculoneuropathy
Intracranial Sinus Thrombosis
Mucormycosis
Leukoencephalopathies
Cerebrovascular Disorders
Intracranial Hemorrhages
Cerebral Hemorrhage
Infection
Brain Neoplasms
Glioma
Medical Records
Early Diagnosis
Lymphoma
Ischemia

Keywords

  • Children, diseases
  • Leukemia

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Chen, C. Y., Zimmerman, R. A., Faro, S., Bilaniuk, L. T., Chou, T. Y., & Molloy, P. T. (1996). Childhood leukemia: Central nervous system abnormalities during and after treatment. American Journal of Neuroradiology, 17(2), 295-310.

Childhood leukemia : Central nervous system abnormalities during and after treatment. / Chen, Cheng Yu; Zimmerman, Robert A.; Faro, Scott; Bilaniuk, Larissa T.; Chou, Ting Ywan; Molloy, Patricia T.

In: American Journal of Neuroradiology, Vol. 17, No. 2, 1996, p. 295-310.

Research output: Contribution to journalArticle

Chen, CY, Zimmerman, RA, Faro, S, Bilaniuk, LT, Chou, TY & Molloy, PT 1996, 'Childhood leukemia: Central nervous system abnormalities during and after treatment', American Journal of Neuroradiology, vol. 17, no. 2, pp. 295-310.
Chen, Cheng Yu ; Zimmerman, Robert A. ; Faro, Scott ; Bilaniuk, Larissa T. ; Chou, Ting Ywan ; Molloy, Patricia T. / Childhood leukemia : Central nervous system abnormalities during and after treatment. In: American Journal of Neuroradiology. 1996 ; Vol. 17, No. 2. pp. 295-310.
@article{1bc04da3eadc49a2904b2ab818906bc7,
title = "Childhood leukemia: Central nervous system abnormalities during and after treatment",
abstract = "PURPOSE: To document the radiologic abnormalities seen in the central nervous system (CNS) during and after treatment of childhood leukemia. METHODS: MR images (19 patients) and CT scans (12 patients) were reviewed retrospectively in 19 children and adolescents with neurologic complications of leukemia or its treatment. Patients were divided into two groups: the first included those with disease related complications of leukemia, such as meningeal and parenchymal leukemia, chloroma, and cerebrovascular disorders; the second included patients with treatment-related neurotoxicity and infection caused by immunocompromised states. Pathologic confirmation of the CNS lesions was obtained in eight patients. Factors that predisposed to the development of tumor related or treatment related complications were determined by reviewing the medical records. RESULTS: 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 ischemia (n = 2), presumed disseminated 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). CONCLUSION: 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.",
keywords = "Children, diseases, Leukemia",
author = "Chen, {Cheng Yu} and Zimmerman, {Robert A.} and Scott Faro and Bilaniuk, {Larissa T.} and Chou, {Ting Ywan} and Molloy, {Patricia T.}",
year = "1996",
language = "English",
volume = "17",
pages = "295--310",
journal = "American Journal of Neuroradiology",
issn = "0195-6108",
publisher = "American Society of Neuroradiology",
number = "2",

}

TY - JOUR

T1 - Childhood leukemia

T2 - Central nervous system abnormalities during and after treatment

AU - Chen, Cheng Yu

AU - Zimmerman, Robert A.

AU - Faro, Scott

AU - Bilaniuk, Larissa T.

AU - Chou, Ting Ywan

AU - Molloy, Patricia T.

PY - 1996

Y1 - 1996

N2 - PURPOSE: To document the radiologic abnormalities seen in the central nervous system (CNS) during and after treatment of childhood leukemia. METHODS: MR images (19 patients) and CT scans (12 patients) were reviewed retrospectively in 19 children and adolescents with neurologic complications of leukemia or its treatment. Patients were divided into two groups: the first included those with disease related complications of leukemia, such as meningeal and parenchymal leukemia, chloroma, and cerebrovascular disorders; the second included patients with treatment-related neurotoxicity and infection caused by immunocompromised states. Pathologic confirmation of the CNS lesions was obtained in eight patients. Factors that predisposed to the development of tumor related or treatment related complications were determined by reviewing the medical records. RESULTS: 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 ischemia (n = 2), presumed disseminated 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). CONCLUSION: 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.

AB - PURPOSE: To document the radiologic abnormalities seen in the central nervous system (CNS) during and after treatment of childhood leukemia. METHODS: MR images (19 patients) and CT scans (12 patients) were reviewed retrospectively in 19 children and adolescents with neurologic complications of leukemia or its treatment. Patients were divided into two groups: the first included those with disease related complications of leukemia, such as meningeal and parenchymal leukemia, chloroma, and cerebrovascular disorders; the second included patients with treatment-related neurotoxicity and infection caused by immunocompromised states. Pathologic confirmation of the CNS lesions was obtained in eight patients. Factors that predisposed to the development of tumor related or treatment related complications were determined by reviewing the medical records. RESULTS: 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 ischemia (n = 2), presumed disseminated 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). CONCLUSION: 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.

KW - Children, diseases

KW - Leukemia

UR - http://www.scopus.com/inward/record.url?scp=0030050403&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030050403&partnerID=8YFLogxK

M3 - Article

C2 - 8938302

AN - SCOPUS:0030050403

VL - 17

SP - 295

EP - 310

JO - American Journal of Neuroradiology

JF - American Journal of Neuroradiology

SN - 0195-6108

IS - 2

ER -