Diagnostic strategies to investigate cerebrospinal fluid involvement in haematological malignancies

Leuk Res. 2013 Mar;37(3):231-7. doi: 10.1016/j.leukres.2012.11.016. Epub 2013 Jan 1.

Abstract

Central nervous system (CNS) involvement is a fatal complication of certain haematological malignancies with an incidence as high as 25% in specific leukaemia/lymphoma subtypes. It is often accompanied by 'occult' cerebrospinal fluid (CSF) involvement at diagnosis, which is frequently missed by conventional cytology examination. Unfortunately, a diagnostic gold standard is yet unavailable since CSF morphology may be negative for malignant cells in up to 45% of patients with suspected meningeal involvement. New technologies such as flow cytometry, molecular genetics and newer biomarkers may improve sensitivity and specificity facilitating the diagnosis of CNS involvement as well as effective prophylaxis and successful treatment.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / cerebrospinal fluid
  • Biomarkers, Tumor / genetics
  • Biomarkers, Tumor / metabolism
  • Central Nervous System Neoplasms / cerebrospinal fluid
  • Central Nervous System Neoplasms / diagnosis*
  • Central Nervous System Neoplasms / secondary*
  • Cerebrospinal Fluid / chemistry*
  • Cerebrospinal Fluid / cytology*
  • Cerebrospinal Fluid / metabolism
  • Diagnostic Techniques and Procedures*
  • Hematologic Neoplasms / cerebrospinal fluid
  • Hematologic Neoplasms / diagnosis
  • Hematologic Neoplasms / pathology*
  • Humans
  • Medical Oncology / methods
  • Molecular Diagnostic Techniques / methods

Substances

  • Biomarkers, Tumor