Differential diagnosis of myelopathy in a patient with relapsed acute lymphoblastic leukemia

Abstract

Leukemia-associated myelopathy is a rare but still underestimated complication. It can be of different etiology, associated with both underlying disease and its specific treatment. It requires differential diagnosis with funicular myelosis, polyradiculoneuropathy, volumetric and hemorrhagic masses, vascular ischemia, dysmetabolic manifestations, as well as with adverse effects of intensive treatment of the primary disease using irradiation, cytostatic, targeted therapy, with paraneoplastic myelopathy and progression of the underlying disease. However, its diagnostics by neuroimaging techniques may proceed later than the onset of appropriate neurological symptoms.We present a clinical case of myelopathy in a 31-year-old patient with acute lymphoblastic leukemia (ALL) which was confirmed by MRI of the spinal cord 2.5 months after the onset of neurological signs. The article presents diagnostic criteria for ALL-associated myelopathy.