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Leukemic Meningitis with CML - How rare is this?

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#1 LivingWellWithCML


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Posted 02 May 2014 - 04:22 PM

Over the past couple of days, there have been two separate patients on Facebook reporting this "rare" situation that developed with their CML spreading into their spinal fluid and potentially into the brain.  What do you all know about this complication and what are the risk factors?

Dan - Atlanta, GA

CML CP Diagnosed March 2011

Gleevec 400mg

#2 Trey


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Posted 02 May 2014 - 09:29 PM

Not very common in CML, but more common in ALL or AML.  This is leukemic cells crossing the blood-brain barrier and taking up residence inside the spinal fluid or brain meninges.  Sometimes it forms a leukemic solid tumor (sarcoma or chloroma).  Sprycel is about the only drug which can  cross over into the spinal fluid to deal with it effectively, so that is the primary treatment option. 

Oncs have a tough time with this.  Most would say it is a serious relapse and a dire situation requiring transplant.  I have even seen discussion about a PCRU patient with the issue, and transplant was discussed.  I am not so sure that in this age of TKI drugs the situation is so dire unless other blast crisis factors are also present.

It is definitely an oddity in CML.  No specific risk factors or rationale for this occurring.

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