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What Complications Occur When Leukemic Cells Are Found In The CSF?

Posted on Fri, 28 Feb 2014

Question: have CLL and I faint quite often. My neurologist did a spinal tap yesterday to see if the leukemic cells spread to my CSF. What complications can occur when leukemic cells are found in the CSF? What is the prognosis? I have decided against treatment so i may live out my life without side effects to medications and for other reasons. But if there is leukemic cells in my CSF how long will I have? I was already given 3-5 years.

Answered by Dr. Saumya Mittal (4 hours later)

Brief Answer: Suggest neuro-imaging Detailed Answer: Hi I am Dr Mittal, MD I read your query. Offering my sympathies. Leukamia can spread and affect the organs like the brain. If csf has been found to have the leukamic cells, the chances are that there is spread of the condition to the brain. Now I would suggest that you get a neuroimaging done like ct scan or mri. If there is a spread, and there is something forming in the brain or spinal cord the pressure symptoms may develop, depending on the region. Say suppose there is a spread to the brain, you may develop problems like seizures and headaches. Similarly if you develop some mass in spinal cord, there may be compression of the nerves and you may develop lower limb weakness. So I request you that please do get the imaging done. Regarding prognosis, it is hard for me to tell, as I did not get a chance to examine you. I would like to answer any further query, if you have any further query Dr Saumya Mittal

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Saumya Mittal (11 hours later)

An MRI was done prior to the spinal tap. However, Nothing was found. My doctors are concerned because I faint about 3-4 times a day. I decided against treatment because I'm in nursing school and I'm almost finished. They already gave me a prognosis of about 3-5 years depending on how it may worsen. But if it is in my csf then I'm assuming it will lessen my time by a lot more, right? Also, if they so happen to find leukemic cells in my CSF, and I decide to do a small amount of chemo, will I be able to continue on through to finish nursing school? I have 5 months left. I also work full time nights as a CNA at a nursing home and I absolutely love it. My doctors say it's okay because it's probably what's been keeping me going so long especially without knowing what was going on. They say I've had since I was about 14. And I'm 20 right now. I'm in stage 3 of CLL, which we know is rare in people my age. But does this help give any more information? My job knows, but my nursing school doesn't because I fainted in lab once and they said if I fainted one more time if be kicked out if the program. I'm in Lvn school not actual RN school. But still it's a goal I would like to achieve. What else can you add or suggest to what's going on? I also get a blood transfusion every two months for anemia due to the leukemia. They also found that I had a deletion of chromosome 17 when I was diagnosed. Hope this helps with any more advice.

Answered by Dr. Saumya Mittal (4 hours later)

Brief Answer: Answering the further query Detailed Answer: Received the second part of your query. I will try to answer it as best as I can. First, I would agree with your doctors that if there is no mass, it is nothing to be worried about. In fact I would take a second look at your csf report. Are there any red blood cells in it? If yes, the tap is probably traumatic, meaning that a bit of blood has entered from the body into the csf, and may have contributed to the finding. I, however, would still suggest that you be careful and let them know as soon as you develop any symptoms that I told you about previously. Now if the leukamia has indeed spread to the CNS, of course the stage of disease increases, and I would prognosticate at a lower duration, but as I said before, there are a huge number of factors needed to decide prognosis. As for the fainting, I think if the MRI Brain was absolutely normal, and did not show any abnormality, including edema, I will say you need to keep a watch on things and meet your doctors regularly. I am sorry that I cannot give you the exact prognosis time, as you requested. As I said, it needs many more factors to look up. Best of luck Dr Saumya Mittal

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Above answer was peer-reviewed by : Dr. Shanthi.E