Deafness in Chronic Myeloid Leukemia

Sudden Bilateral Deafness from Hyperleukocytosis in Chronic Myeloid Leukemia

“…The appearance of deafness during leukapheresis [24]and on rising after sleep [28], and the fluctuations in hearing loss in our patient and in other published cases [21], suggest a vascular pathogenesis of deafness, probably due to leukostasis and hyperviscosity in the labyrinth artery and other small brainstem blood vessels originating from the vertebrobasilar region.…”

“…In isolated reports, deafness preceded CML diagnosis by 15 days [17], case 2], it appeared during leukapheresis [24]and on rising, after sleep [28], case 1]. The deafness can be unaffected by [25, 26, 28]or improve with a reduced white blood cell count [21]. …”

“…However, deafness arising from CML is rare. No cases were mentioned among 36 CML patients in a review on the neurological manifestations of hematological neoplasia [15], and we found only 27 cases in 16 published papers [8, 10, 11, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28]. Our objective was to present a review of the relevant literature and to describe an additional clinical case, with neurological changes documented by electric brainstem auditory-evoked responses (BAEP) and magnetic resonance imaging (MRI), which help understanding the pathogenesis of deafness from hyperleukocytosis.…”

“…The deafness was generally described as bilateral [10, 22, 24, 25], of the sensorineural type [10, 24, 25], sudden [22, 25], beginning as unilateral hypoacusis and developing into bilateral deafness [23, 28]or staying unilateral [17, 26]. Different degrees of hypoacusis are also described [11].…”

“…These are described, in decreasing order of frequency: tinnitus [8, 11, 17, 28], vestibular syndrome [17, 23, 26, 28], retinal alterations [8, 16, 17, 23], gait ataxia [11, 20, 21], papilledema [16, 17], campimetric alterations [16], blindness [10]. There are no details whether the ataxia was cerebellar, vestibular or due to impairment of the spinal cord.…”