Central nervous system emergencies in haematological malignancies

Br J Haematol. 2020 Jun;189(6):1028-1037. doi: 10.1111/bjh.16184. Epub 2019 Sep 4.

Abstract

Neurological emergencies are frequently catastrophic events in the course of haematological malignancies (HM) that, if not promptly recognized and treated, may lead to lethal outcomes or chronic sequelae. They may occur at any time during the disease course, but are more frequently observed following relapse. Practice guidelines are lacking in the management of most central nervous system (CNS) complications in HM. Herein we review the pathophysiology, presentation and treatment of elevated intracranial pressure, spinal cord compression, status epilepticus, neurovascular complications, CNS infection, leucostasis and hyperviscosity. Further, we discuss the expanding spectrum of neurological complications of old and novel treatments in HM.

Keywords: central nervous system; emergencies; haematological malignancies.

Publication types

  • Review

MeSH terms

  • Hematologic Neoplasms* / complications
  • Hematologic Neoplasms* / pathology
  • Hematologic Neoplasms* / therapy
  • Humans
  • Intracranial Hypertension* / diagnosis
  • Intracranial Hypertension* / pathology
  • Intracranial Hypertension* / therapy
  • Practice Guidelines as Topic
  • Spinal Cord Compression* / etiology
  • Spinal Cord Compression* / pathology
  • Spinal Cord Compression* / therapy
  • Status Epilepticus* / etiology
  • Status Epilepticus* / pathology
  • Status Epilepticus* / therapy