blood cancer

Leukemia Cells - Fast Moving Cancer to the Nervous System

Dr. Kapil Kumar
15 Nov 2018
 4.51 Vote(s)
Visits: 10815

Leukemia cells can spread to centralnervous systemnot by breaching the blood-brain barrier but by actually evading it. Leukemia normally refers to cancer of White Blood Cells. Leukemia can also spread to other parts of your body, including lungs, heart, kidney and testes.

Leukemia is a cancer that usually begins in bone marrow and results in large production of abnormal cells. There are different categories of blood cells, which include red blood cells (RBCs), white blood cells (WBCs), and blood platelets. Generally, leukemia refers to cancer of White Blood Cells. White Blood Cells form an important part of immune system; they protect the body from invasion by viruses, fungi, bacteria and other abnormal cells and foreign bodies. Those white blood cells, which are not fully matured, are called blasts or leukemia. When a person is suffering from leukemia, the White Blood Cells do not function like normal WBCs; they eventually crowd out normal cells and divide faster than the normal cells.

White Blood Cells are mostly produced inbone marrow, but certain types of WBCs are also made in thymus gland, lymph nodes and spleen, they circulate throughout body in blood and lymph, concentrating more in the lymph nodes and spleen areas.

The symptoms of blood cancer occur due to lack of normal blood cells. The symptoms may include the following:

  • Not feeling well for most of the time. This may be due to having fewer normal bone marrow cells which on turn causes aches in the legs, arms and hips.
  • Mild fever with enlarged lymph nodes or swollen gums
  • Bleeding and bruising problems
  • Feeling tired very easily because having fewer healthy red cells may lower shortness of breath and energy levels. A person with leukemia may also have a very pale skin color; feel short of breadth most of the time while doing day-to-day activities
  • An increased risk of infections
  • Excessive weight loss due to loss of appetite and eating lesser than the usual days
  • Black and blue marks on the body. Due to low platelet count a person may have pinhead-sized red spots to bruise more easily or to have tiny red spots called petechiae on the skin
  • Bleeding for a longer time from minor cuts bleeding time or slower healing of cuts
  • Leukemia can also cause symptoms in other parts of the body like the organs that have been infiltrated or affected by the cancer cells

Leukemia can also spread to other parts of your body, including:

 Leukemia and Central Nervous System

The Central nervous system is one of the most sensitive organs in the human body; it is one of the main controllers of the human body. It controls important parts like brain, neurons, spinal cord and transmitters that play an important role in regular body functions. Nowadays an increasing number of patients are suffering from Central nervous system leukemia (CNSL), which is extremely difficult for treatment. 

Leukemia affects the central and peripheral nervous system and as blood cancer can find its way into the brain. Central nervous system lymphoma is very rare but once the leukemia reaches the brain, the patient is at a considerable risk and may experience seizures, problems with balance, problems with vision, and headaches. 

 In order to prevent leukemia from reaching the central nervous system, patients may receive a type of chemotherapy known as "intrathecal chemotherapy".Because the eye is so close to the brain, primary CNSL can also affect the eye called as ocular lymphoma. The cancer can also start in the spinal fluid that bathes the spinal cord and brain. This is called leptomeningeal lymphoma. 

CNSL is more common in men as compared to women. The median age of diagnosis is 55 years for both men and women while the median age for AIDS-infected patients with primary CNSL is 35.

If the cancer spreads to the central nervous system, then one can experience the following symptoms:

  • Repeated headaches
  • Nausea and vomiting
  • Leg and arm weakness
  • Changes in mental alertness or confusion
  • Loss of muscle control and seizures
  • Facial weakness, double vision and hearing loss and/or swallowing difficulties

Patients with lymphoma involving their spinal cord or spinal fluid may experience back pain, leg weakness or incontinence while patients with ocular lymphoma may notice blurry vision.

Causes and Risk Factors

Although the exact causes of CNSL are not clear, several factors can increase a patient's risk for developing it, such as chronic immune-suppression. It is a case where a person has weak immune system because of organ transplantation, acquired immunodeficiency syndrome (AIDS) and other disorders of the immune system.


Diagnosis of secondary and primary CNSL can be difficult due to unspecific signs and symptoms, limited accessibility of brain and low sensitivity. Diagnosis includes examination of eyes, brain and spinal cord, which is used to find and diagnose CNSL. Tests also include physical examination and the patient’s medical history.

1. Neurological examination

Neurological examination to check the mental status, coordination, ability to walk normally and how well the muscles, senses and reflexes work. 

2. Slit-lamp eye tests

Slit-lamp eye examination uses a special microscope with a bright, narrow slit of light to check the outside and inside of the eye.

slit eye test

3. Vitrectomy

Vitrectomy is a surgical procedure in which some of the vitreous humor a gel-like fluid inside the eyeball is removed and examined under a microscope to check for cancer cells.

4. X-ray and CT scans

X-ray is done for the chest and CT scans of the chest and abdomen. An MRI scans for the brain and spinal cord.

5. Blood and Urine Tests

A complete blood count is a common test that gives a general picture of the number of red cells, white cells (neutrophils, eosinophils, basophils, monocytes and lymphocytes) and platelets and the levels of hemoglobin and hematocrit in blood. Doctor can also order a CBC regularly to monitor patient’s condition or track response to treatment.

Blood and Urine test

6. Lumbar Puncture (or spinal tap)

Lumbar puncture or spinal tap is a medical procedure in which a needle is inserted into the patient’s spinal canal to collect cerebrospinal fluid (CSF) for diagnostic testing. 

7. Stereotactic biopsy

Stereotactic biopsy requires a three-dimensional scanning device and a computer to find a tumor and guide the removal of tissue for examination under a microscope to look for cancer cells.

Stereotactic Biopsy

8. Staging

A series of tests may be done to determine different stages of cancer or how far the cancer has spread. The information obtained is then used to stage the disease and plan treatment. 

Treatment of Leukemia

Since the exact cause of CNSL is still unclear, there is no standard treatment for CNS lymphoma. CNSL is extremely rare; it only affects a small number of people, so firstly it becomes important for you to discuss your treatment with a hematologist/oncologist who is knowledgeable about Central Nervous System Leukemia. Make sure you consider getting a second opinion with an NHL expert to be aware of all possible treatment options.

Some of the Treatment Options are given below:

Methotrexate-based combinations 

Methotrexate-based combinations include rituximab (Rituxan), which have been one of the most successful treatments for CNS lymphoma patients. Methotrexate is usually given to patients in high doses with chemotherapy treatment. For patients over the age group of 55-60 years, radiation treatment can be harmful and extremely neurotoxic, so it is important to speak to your doctor before receiving this treatment. 

Other Treatment options for CNS lymphoma include:

  • Chemotherapy followed by radiation therapy
  • Steroid therapy
  • Whole brain radiation therapy
  • High-dose chemotherapy with stem cell transplant

Treatment options for AIDs-related CNS lymphoma include:

  • Treatment with HIV medications
  • Steroids with or without radiation
  • Chemotherapy with or without radiation therapy
  • Treatment for recurrent CNS lymphoma 

A Clinical Trial

For some patients, taking part in several clinical trials for examining the role of radiation and role of bone marrow transplantation can be beneficial for the treatment of primary CNS lymphoma. You can always approach your doctor to see if these clinical trials are appropriate or available for you. 

Treatment Outcomes

Treatment of CNSL is most effective when the tumor is still in the minor stage or has not spread outside the cerebrum, the largest part of the brain. In addition, if the patient is under 60 years and does not have AIDS or other diseases that weaken the immune system, CNSL Treatment can yield successful results.

Although medical science is still in search of specific pathology to counter the pathway of how leukemia reaches the central nervous system or how it can be treated and managed, there can be some therapeutic benefits that could open novel ways to drug design that forbids an all cell invasion into the CNS.

We hope you found this article about leukemia and its invasion to the Central Nervous System, quite informative. If you want to uncover more facts and possible treatments of Leukemia, you can follow Elacancer blog or call us at +91-8929020600 for proper support and guidance.


Dr. Kapil Kumar

About the Author

Surgical Oncologist
Dr. Kapil Kumar is an Oncologist and cancer specialist practicing at BLK Hospital in Rajendra Place, Delhi. He specializes in Breast cancer, Oncoplastic surgery, Upper G.I. Onco surgery, Pancreatic Biliary surgery, and Thoracic surgery including Esophagus cancer. He has completed his MBBS from Amritsar Government Medical College and Hospital. Further, he pursued MS from Amritsar Government Medical College and Hospital. Dr. Kapil is a member of Indian Society of Oncology (I.S.O.) and International Society of Diseases of Esophagus. He is also a member of Delhi Medical Association (D.M.A.). He got Dhanvantari award from Cholay 1 Foundation for Onco- Surgery work. He has worked in various hospitals as Senior Consultant Oncologist. Dr. Kapil has an experience of more than two and a half decade in this field. BLK Hospital is JCI, NABH and NABL accredited. It is one of the most successful and largest private sector hospitals situated in Delhi. Book appointment with Dr. Kapil Kumar at
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1 Comment

Valmiki, Valmik Surujnarine
Nov. 15, 2018, 12:19 p.m.
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