Neurologic Complications in Adult Hematologic Malignancies in Songklanagarind Hospital : Prevalence and Clinical Patterns
Keywords:
Neurologic complications, Hematologic malignancies, Prevalence, Clinical patterns, Meningeal involvement, Retrospective studyAbstract
Abstract : Objectives : To determine the prevalence and clinical features of neurologic complications in aquit patients with hematologic malignancies; and to identity the association between types of malignancies and clinical patterns of neurologic complications. Study design : Retrospective descriptive study Setting : Single center, Songklanagarind University Hospital
Materials and methods : Adult patients(age > 15 years) with the diagnosis of leukemia, Iymphoma and multiple myeloma admitted during January 1987 and December 19996. The diagnosis of neurologic complications was based on clinical manifestations and additional laboratory investigations The data extracted for medical records included age, sex, type of malignancy, stage of disease, neurological symptoms and signs, additional investigations, treatment and result. Results : Of total 1,683 patients with hematologic malionancies 1.545 medical records (91.3%) can be found. Of those, 173 patients (11 2%) had neurologic complications. They were intracranial hemorhage 39 3%, meningeal involvement 23 7%, spinal cord compression 16 8%, intracranial mass 6 9%, and penipheral nerve compression 46%. The prevalences of neurologic complications of acutelymphoblast leukemia (ALL), acute nonlymphocytic leukemia (ANLL), chronic myeloid leukemia (CML), non-Hodgkin's Iymphoma (NHH), Hodgian's disease (HD) and multiple myeloma (MM) were 13.0%, 116%, 16.1% 10.3%, 69% and 9.9.99%, respectively. Excluding intracral hemomonhage, the prevalences of neurologic complications of each type of hematologic malignancy were 8.7%, 1.9%, 4.0%,79.7%, 56% and 9.2% respectively. There were signt association between types of hematologic malionancies and pattems of neurologic comblications / p < 0.00t). Concerming specic complications, intracranial hemorhage was found in 9.9.6% of patients with ANLL; meningeal invokement were found in 7.5% of ALL patients and in 3.7% of NHL patients; and spinal cord compression was common in in patients with multiple myeloma (66%), HD (2.8%) and NHL (2.3%). Conclusion : Neurological complications are not uncommon, but important in patients with hematologic
malignancies. They are significantly associated with specific type of neoplasms. Early diagnosis will bring to proper management and reduce serious morbidity.
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