Isolated central nervous system relapse in blast crisis of chronic myeloid leukemia: a case report
Chronic myeloid leukemia (CML) typically progresses from a chronic phase to an accelerated phase, and eventually to a blast crisis, often involving the bone marrow and peripheral blood, if left untreated. Central nervous system (CNS) involvement is an uncommon manifestation of CML, particularly as a...
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| Format: | Article |
| Language: | English |
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Yeungnam University College of Medicine, Yeungnam University Institute Medical Science
2025-01-01
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| Series: | Journal of Yeungnam Medical Science |
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| Online Access: | http://www.e-jyms.org/upload/pdf/jyms-2025-42-17.pdf |
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| author | Hari Priya Raghvan Caroline Ho Siew Ling Wee Shiang Yui Boo Yang Liang Ehram Jamian Indhira Subbiah |
| author_facet | Hari Priya Raghvan Caroline Ho Siew Ling Wee Shiang Yui Boo Yang Liang Ehram Jamian Indhira Subbiah |
| author_sort | Hari Priya Raghvan |
| collection | DOAJ |
| description | Chronic myeloid leukemia (CML) typically progresses from a chronic phase to an accelerated phase, and eventually to a blast crisis, often involving the bone marrow and peripheral blood, if left untreated. Central nervous system (CNS) involvement is an uncommon manifestation of CML, particularly as an isolated CNS relapse. Here, we present a rare case of CML in lymphoid blast crisis with an isolated CNS relapse. A 46-year-old female with underlying CML in lymphoid blast crisis, previously treated with chemotherapy and tyrosine kinase inhibitors, presented with visual disturbances. Imaging and cerebrospinal fluid analysis confirmed leukemic infiltration of the CNS without evidence of a systemic disease. Isolated CNS involvement is an atypical complication of CML and presents significant therapeutic challenges owing to the blood-brain barrier, which limits the efficacy of systemic therapies. Subsequently, the patient was treated with intrathecal chemotherapy targeting the CNS. Despite aggressive treatment, CNS relapse remains a major concern due to the limited penetration of standard therapies into the CNS. This case underscores the importance of early recognition of CNS symptoms in CML patients, particularly in those with blast crisis, and highlights the need for tailored therapeutic strategies to manage this rare and challenging manifestation. |
| format | Article |
| id | doaj-art-47593cbb02204d43b067248efb200af2 |
| institution | Kabale University |
| issn | 2799-8010 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Yeungnam University College of Medicine, Yeungnam University Institute Medical Science |
| record_format | Article |
| series | Journal of Yeungnam Medical Science |
| spelling | doaj-art-47593cbb02204d43b067248efb200af22025-02-11T06:26:37ZengYeungnam University College of Medicine, Yeungnam University Institute Medical ScienceJournal of Yeungnam Medical Science2799-80102025-01-014210.12701/jyms.2025.42.172879Isolated central nervous system relapse in blast crisis of chronic myeloid leukemia: a case reportHari Priya Raghvan0Caroline Ho Siew Ling1Wee Shiang Yui2Boo Yang Liang3Ehram Jamian4Indhira Subbiah5 Haematology Unit, Department of Pathology, Hospital Sultanah Aminah, Ministry of Health, Johor Bahru, Malaysia Haematology Unit, Department of Pathology, Hospital Sultanah Aminah, Ministry of Health, Johor Bahru, Malaysia Haematology Unit, Department of Pathology, Hospital Sultanah Aminah, Ministry of Health, Johor Bahru, Malaysia Clinical Haematology, Department of Medicine, Hospital Sultanah Aminah, Ministry of Health, Johor Bahru, Malaysia Haematology Unit, Department of Pathology, Hospital Sultanah Aminah, Ministry of Health, Johor Bahru, Malaysia Haematology Unit, Department of Pathology, Hospital Sultanah Aminah, Ministry of Health, Johor Bahru, MalaysiaChronic myeloid leukemia (CML) typically progresses from a chronic phase to an accelerated phase, and eventually to a blast crisis, often involving the bone marrow and peripheral blood, if left untreated. Central nervous system (CNS) involvement is an uncommon manifestation of CML, particularly as an isolated CNS relapse. Here, we present a rare case of CML in lymphoid blast crisis with an isolated CNS relapse. A 46-year-old female with underlying CML in lymphoid blast crisis, previously treated with chemotherapy and tyrosine kinase inhibitors, presented with visual disturbances. Imaging and cerebrospinal fluid analysis confirmed leukemic infiltration of the CNS without evidence of a systemic disease. Isolated CNS involvement is an atypical complication of CML and presents significant therapeutic challenges owing to the blood-brain barrier, which limits the efficacy of systemic therapies. Subsequently, the patient was treated with intrathecal chemotherapy targeting the CNS. Despite aggressive treatment, CNS relapse remains a major concern due to the limited penetration of standard therapies into the CNS. This case underscores the importance of early recognition of CNS symptoms in CML patients, particularly in those with blast crisis, and highlights the need for tailored therapeutic strategies to manage this rare and challenging manifestation.http://www.e-jyms.org/upload/pdf/jyms-2025-42-17.pdfblast crisisblood-brain barriercentral nervous system chronic myeloid leukemia |
| spellingShingle | Hari Priya Raghvan Caroline Ho Siew Ling Wee Shiang Yui Boo Yang Liang Ehram Jamian Indhira Subbiah Isolated central nervous system relapse in blast crisis of chronic myeloid leukemia: a case report Journal of Yeungnam Medical Science blast crisis blood-brain barrier central nervous system chronic myeloid leukemia |
| title | Isolated central nervous system relapse in blast crisis of chronic myeloid leukemia: a case report |
| title_full | Isolated central nervous system relapse in blast crisis of chronic myeloid leukemia: a case report |
| title_fullStr | Isolated central nervous system relapse in blast crisis of chronic myeloid leukemia: a case report |
| title_full_unstemmed | Isolated central nervous system relapse in blast crisis of chronic myeloid leukemia: a case report |
| title_short | Isolated central nervous system relapse in blast crisis of chronic myeloid leukemia: a case report |
| title_sort | isolated central nervous system relapse in blast crisis of chronic myeloid leukemia a case report |
| topic | blast crisis blood-brain barrier central nervous system chronic myeloid leukemia |
| url | http://www.e-jyms.org/upload/pdf/jyms-2025-42-17.pdf |
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