Table 1 Literature review from 2005 to 2015. characterization of acute myeloid leukemia associated to spinal cord compression
Nb | References | Sex/age (years) | Cytogenetic | Histology and immunohistochemistry | Localization | signs | MR Imaging | Laboratory findings | Delay and diagnosis treatement and outcome |
|---|---|---|---|---|---|---|---|---|---|
1 | Meltzer et al. 2005 [3] | M/10 | - | -Myeloblastic Acute myeloid leukemia -Chloroma | T2-T6 | -Midback pain -weight loss -decreased sensation to vibration and light touch over the left leg -decreased sensation to pain and temperature in the right leg | -paravertebral lesions with spinal -posterior epidural and prevertebral mass | WBC 12,800/mm3, HB 9.4 g/dl, platelet 74,800/mm3. -lactate dehydrogenase was 570 IU/l, -immature cells | -3 weeks -Laminectomie + Chemotherapy + spinal radiation -Total Neurological improvement after 6 month -well more than 18 months of therapy |
2 | Ghalaut et al. 2005. [4] | 23/M | - | Granulocytic sarcoma due to acute myeloid leukemia | T4-T6 | -Backache -numbness of bilateral legs-sensory loss up to mid thoracic region anemia | -Epidural mass extending from T4-T6 with marrow signal alteration involving T1 and T5 to T7 | - | - surgical excision + chemotherapy -neurological improvement |
3 | Amalraj et al. 2009 [5] | 14/M | - | Granulocytic sarcoma promyelocytic leukemia AML M3 | T3-T10 | -Acute paraplegia -weakness of both lower limbs -numbness of both lower limbs -back pain for the last -bladder symptoms | hypointense in T1 hyperintense in T2 dorsally compressing the spinal cord | Hemoglobin 13 gm%, total count 8,400, polymorph 60 %, and lymph 40 %, with high erythrocyte. | -paraplegia improved with radiotherapy and chemotherapy |
RBC mild hypochromic microcytic, WBC count normal predominantly blast cells with high nuclear cytoplasmic ratio, moderate cytoplasm, hyperchromatic nuclei with multiple nucleoli, platelet count decreased. | |||||||||
4 | Olcay et al. 2009 [6] | M/12 | Cytogenetic evaluation could not be done. | acute myeloblastic leukemia | Lumbar (L3) -Conus medullaris -left maxillary mass | -Conus medullaris syndrome | Cauda equine nerve roots were thickened and clumped in the left anterolateral side of the spinal canal. | Hb:8 g/dL | -Chemotherapy + triple intratecal therapy -Radiotherapy -Symptom partially resolved died because of pneumonia and disseminated intravascular coagulation |
CD45:95.15 %, CD15: 35.56 %, CD33:77.57 %, CD117:79.3 %, CD34:43.38 %, CD13:29.32 %. | WBC : 7.4 × 109/mm3 | ||||||||
Thrombocyte:60.109/mm3 | |||||||||
Lactate dehydrogenase: 691 U/l | |||||||||
HLA-DR:86, 4 %, CDw65:23.9 %, CD19:49.54 % CD20:21.65 %, CD14:3.14 %. | |||||||||
5 | Yin et al. 2010 [7] | 28/M | - | myeloid sarcoma with acute myeloid leukemia | T12-L1 | -low back pain -numbness of his legs -bladder -incontinence -hypoesthesia below T12 paraparesis | -Posterior epidural mass T12-L1 | White blood cell 3,900/mm3 - hemoglobin :11.0 g/dL -hematocrit of 38.2 %. | High-dose methylprednisolone |
-Decompression with T12-L1 laminectomy and tumor resection. | |||||||||
CD68, CD45, CD43, CD117 and lysozyme but not of MPO, CD20 | |||||||||
Paraparesis Improvement | |||||||||
- anti-AML therapy, but died of sepsis | |||||||||
7 | Bittencourt et al. 2011 [8] | 53/M | t(15;17)(q22q21) abnormality | -Acute promyelocytic leukemia presenting as extradural mass -PCR for the PML-RARα gene was positive | T6-T8 | -Progressive fatigue, pain legs weakness Paraparesis - Gingival hemorrhage, hepatomegaly | Posterolateral extradural mass from T6-T8 with medullar compression | Hb:10,6 g/dl-1 | delais4 months/chemotherapy (daunorubicin) + radiotherapy/Evolution: no neurologic improvement + died of sepsis |
WBC: 7,5.109/L-1 | |||||||||
Platelet:12.109/l-1 | |||||||||
Fibrinogen:1.4 g/L-1 | |||||||||
INR: 1.86 (N:0,8-1,2) | |||||||||
Uric acid and lactate dehydrogenase were both elevated | |||||||||
8 | Kyaw et al. 2012 [9] | 26/M | - | -Myeloid sarcoma: acute promyelocytic leukemia -CD33, CD117, CD64, CD34 and cytoplasmic MPO were presented Reverse transcriptase-polymerase chain reaction showed BCR1-type PML-RARα fusion copies | T2-T4 and T12 – L2 | Progressive back pain and bilateral leg weakness: -paraparesis Loss of pain and sensory perception | Multiple hyperintense T12,L1,L2, L4 and L5 vertebral bodies and sacrum | Hb:10,7 g/dL-1 | -Radiotherapy -Chemotherapy: retinoic acid + ida rubicin -Neurological improvement -Good remission |
WBC:2,8.109/L-1 | |||||||||
Platelet : 102.109/L-1 | |||||||||
Intraspinal extradural masses L4 and L5 vertebral bodies and sacrum | |||||||||
Intraspinal extradural masses located fromT2 toT4 and T12 to L2. | |||||||||
9 | Ben et al. 2013 [10] | 21/M | karyotype: 46, XY, t (8, 21) (q22; q22) / 46, XY | chloroma CD3, CD20 = - -positive for myeloperoxidase acute myeloblastic leukaemia (AML) of the French-American-British M2 subtype | T4/ T7, T1-T2 | Progressive paraplegia. urinary retention | intermediate in T1, hyperintense in T2 | hemoglobin 8 g/dL-1, white blood cell count 3100/mm3, platelet count 44000/mm3 and 3 % neutrophils, 44 % lymphocytes and 44 % . | laminectomy + tumour was totally removed |
-rubidomycine (45 mg/m2 daily for 3 days) and cytosine arabinoside (200 mg/m2 continuous infusion for 7 days). -improvement paraplegia - complete remission | |||||||||
10 | Krishnamurthy et al. 2014 [11] | 16 /M | - | Granulocytic sarcoma associated with leukaemia, - acute myeloblastic leukaemia (AML) of the French-American-British M2 subtype. -subleukemic leukemia | Low backaches follow proptosis, spinal cord causing significant compression of the spinal cord. | Multiple midline fusiform extra-dural masses which are iso- intense to cord on T1W images seen extending from C3- C7, D3-D5, D11-D12 & S1-S2 are seen posteriorly | Hb : 7.2 g/dl, 3 RBC 2.5 million/mm3,TC : 11200 cells/mm3, with a differential ount of N 41 %, L-28 %, E-01 %, M-30 %, 3ESR 120 mm/hr, Platelet count: 51,000/mm3, PT/INR – - dimorphic anemia, thrombocytopenia and myeloblasts | -radiotherapy and chemotherapy | |
11 | Present case. | 17/M | -Cytogenetic evaluation could not be done. | -Myeloid leukemia - type 2 leukemia | T4T9 | Acute paraplegia | hypointense lesion on T1 weighted sequence isointense T2 weighted sequence enhanced on T1 with gadolinium. (epidural mass (hyperintense) | blood count revealed leucocytosis with a major white blood cell count 200,000 / mm3, with 77 % blasts, hemoglobin: 10.9 g dl; platelet count: 106 × 109 L-1 | -Chemotherapy -Died one week after diagnosis |