Shaheen Kouser, Khalid Zafar Hashmi.
Frequency of central nervous system involvement in acute myeloid leukemia.
J Coll Physicians Surg Pak Jan ;17(6):378-9.

It was an observational study, conducted from January 2000 to December 2001 at the department of haematology at Liaquat National Hospital, Karachi. A total of 20 newlydiagnosed cases of AML, of all ages and either gender, with or without CNS symptoms were included in the study. Patients who were on chemotherapy and transformed AL patients were excluded. In 20 AML patients, M:F ratio was 3:1; mean age was 30 years (01 to 54 years), mean WBC count 42,000/l (2400 to 300,000/l). Futher subdivision of 20 patients according to morphology was M0 =1, M1=1, M2=6, M3=2, M4=6 and M5=4 according to morphology. For the diagnosis of CNS leukemia based on CSF cytology, Leishman stained slides of cytospin preparation were used for cytological examination. The overall frequency was such that ( 7/20 i.e 35% were showing positive cytology, while 6/20 showed increased leukocyte count >50000/l WBC. Seventeen were in >12 years group among whom 06 showed positive CSF cytology. Three were in <12 years age group and only 01 patient had positive result. In morphological subtypes, 2/6 in M2, 3/6 in M4, 2/4 in M5 category showed positive cytology. Hyperleucocytosis and monocytic morphology was the prominent feature associated with CNS involvement in this study. In this study, the frequency of CNS involvement in AML was 35%. The internationally reported incidence varied from 10% - 30%. Meyer et al.5 reported an incidence of 18% for adults with AML.

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