Pediatric leukemia is now better treated, but the road to fighting “white” is long and winding, with many stumbling blocks such as “infection, bleeding, and relapse”. Today, Dr. Wu will talk to you about one of these stumbling blocks – central nervous system leukemia (referred to as “cerebral white”).
What is cerebral leukemia?
Leukemia cells infiltrate into the meninges or brain parenchyma, causing patients to exhibit corresponding neurological and/or psychiatric symptoms. Cerebral white can occur at any stage of the leukemia process.
Why does leukoencephalitis occur?
Because multiple chemotherapeutic agents do not easily cross the blood-brain barrier, leukemic cells hidden in the central nervous system cannot be effectively killed and become a refuge for leukemic cells, becoming the primary cause of extramedullary leukemia relapse.
Which types of leukemia are prone to cerebral leukemia?
Compared to acute granulocytic leukemia, acute lymphoblastic leukemia is more likely to develop cerebral white. Acute T-lymphocytic leukemia, acute granulocytic leukemia (AML-M4), acute monocytic leukemia (AML-M5), all of these types of leukemia are at high risk for developing cerebral leukemia.
What are the signs of Cerebral Leukemia?
Children may have headaches, nausea, vomiting, and sleepiness. Some children may have weakness of the lower limbs, crookedness of the mouth (facial nerve palsy), and in severe cases, children may have seizures and coma. However, some children may have no clinical manifestations at all, and abnormal laboratory results are found during routine lumbar puncture examinations.
How is cerebral white diagnosed?
A lumbar puncture of the cerebrospinal fluid is the definitive diagnosis of cerebral leuko, and depending on the condition, tests such as a cranial MRI may be an option.
How is cerebral white treated?
Lumbar puncture followed by intrathecal injection of chemotherapy drugs (commonly known as “sheathing”) is the main method of treatment for cerebral leukemia.
How to prevent cerebral white?
In addition to cranial radiotherapy, the above-mentioned treatment modalities for cerebral white – sheath injection chemotherapy drugs, high-dose methotrexate, and high-dose cytarabine chemotherapy – are now widely used for the prevention of cerebral white.
Conclusion: It is reassuring to note that in recent years, the incidence of cerebral white has been significantly reduced in various pediatric hematology treatment centers as a result of effective preventive measures. The incidence of cerebral white can certainly be minimized by following the treatment advice of doctors and taking active preventive measures.