September 22 is World CML Day. Any brain connection?

 September 22 2017 is marked as World Chronic Myeloid Leukaemia Day.
You might want to ask ' what is the connection between chronic myeloid leukaemia (CML) and the neurological axis?' Well, quite a lot it seems.
Neurological complications can result from direct or indirect effects of leukaemia and may be iatrogenic (treatment induced). It is critical to identify them and treat appropriately.
Meningeal spread is typically seen in the acute leukaemias as chronic leukaemias rarely affect the leptomeninges. Solid masses called 'chloromas' and brain haemorrhages are also commoner in the acute leukaemias.
The leukaemic cells can infiltrate to cause blockage of venous sinuses in the brain and thus haemorrhagic infarctions.
During treatment with various medications (cytotoxic chemotherapy, steroids etc) significant damage to the neurological system can result. Various agents used are associated with particular patterns of effects.
An acute or chronic delirium (encephalopathy) may be encountered just may be seizures, headaches, visual loss, cerebellar dysfunction, aseptic meningitis or vascular syndromes. Peripheral neuropathy from chemotherapy is also common and this is usually in form of a sensory neuropathy. Autonomic, motor and cranial neuropathies are less common.
Radiation therapy in leukaemias can cause neurological complications which can be acute (during or immeditely after treatment), subacute (within 6 months of therapy) or chronic (after 6 months).
Leukaemias are best managed by specialist doctors called haematologists/ oncologists and can be found in major tertiary centres across the country including UNTH Enugu.
Currently in Nigeria, radiation therapy is said to be offered at National Hospital Abuja while the centres at UNTH Enugu and UCH Ibadan are yet to come back on stream.
So, our hearts and best wishes go out to all CML patients. Happy survival!!
Neurologist, Professor, Researcher, Scientist, Mentor.

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