Diagnosis and treatment of chronic myeloid leukemia with the initial symptoms of intracranial space-occupying lesion

Objective To investigate the clinical characteristics and prognosis of chronic myeloid leukemia(CML) with the initial symptoms of intracranial space-occupying lesion. Methods The clinical features of a 49 years old CML female patient with the initial symptoms of intracranial occupying lesions in the Affiliated Hospital of Southwest Medical University were analyzed.And the literatures were reviewed and summarized. Results The main clinical manifestations of the patient were headache and blurred vision.Cranial CT showed space occupying lesions in the left frontal lobe.The white blood cell counts(WBC) was 360.09×109/L.Bone marrow smear showed 87.0% of granulocyte and 13.5% of primitive granulocytes, and the patient was diagnosed as CML(accelerated phase). The patient was treated with imatinib 600mg qd, and the disease was controlled.Her intracranial mass was disappeared, and achieved long-term disease-free survival.Imatinib on CML intracranial lesions also had certain curative effect. Conclusion Tyrosine kinase inhibitors(TKIs) should also be individualized for different patients.Dasatinib is the first choice for CML with intracranial occupying lesions.However, this case suggests that imatinib also has clinical efficacy.It may be related to the release of intracranial tumor cells into the peripheral blood or imatinib, and also a small amount of penetration through the blood-brain barrier.In the treatment of CML, appropriate TKIs should be chosen according to the patients' condition. Key words: Leukemia, myeloid, accelerated phase; Brain diseases; Case reports