Isolated central nervous system blast crisis in chronic myeloid leukemia - Report of two cases

Abstract

AbstractExtramedullary blast crisis (BC) presenting as the central nervous system (CNS) involvement in chronic myeloid leukemia (CML) is rare and usually accompanies systemic involvement. Imatinib has shown efficacy in treating patients with CML in accelerated or blastic phases. However, CNS penetration of Imatinib is poor due to the P-glycoprotein mediated efflux mechanisms. Therefore, patients on long-term Imatinib therapy with hematological and cytogenetic remission may rarely present with CNS BC. Isolated CNS BC is uncommon and the literature is limited to only a few case reports. Here, we present two cases of isolated CNS BC in patients with BCR ABL positive CML on treatment.