Hearing Loss due to Infiltration of the Tympanic Membrane by Chronic Lymphocytic Leukemia

Cohen, Jonathon B.; Cavaliere, Robert; Byrd, John C.; Andritsos, Leslie A.

doi:10.1155/2012/589718

Cited by 3 publications

(3 citation statements)

References 12 publications

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“… 213 43 65 F Difficulty speaking, weakness in the right arm and leg 1 month Rai IV 600,000 (WBC) 13q14 deletion (biopsy) Biopsy Cyclophosphamide + steroids FCR WBRT Rtx–bendamustine CR Case Rep Hematol. 2012 589,718 44 66 F Bilateral hearing loss NA NA 104,000 (WBC) del(17p13.1) and del(13q34) Tympanic membrane biopsy CSF + Rtx-CVP Rtx IT liposomal cytarabine Cyclophosphamide, cladribine, and Rtx HyperCVAD PR Am J Hematol. 2011.86.783 45 73 Bilateral visual loss NA Rai II Binet B NA NA Ethmoidectomy Fludarabine/FCR Steroids RT PD J Neurol Neurosurg Psychiatry.…”

Section: Discussionmentioning

confidence: 99%

Refractory Chronic Lymphocytic Leukemia with Central Nervous System Involvement: A Case Report with Literature Review

Nakanishi

Ito

Fujita

et al. 2020

JBM

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There have been few reports on central nervous system (CNS) involvement in chronic lymphocytic leukemia (CLL). This is an extremely rare disease with poor prognosis, owing to resistance to various treatments. We describe a 33-year-old man with intractable CLL with CNS involvement. He was diagnosed with CLL, with diplopia as the first manifestation. Magnetic resonance imaging revealed a contrast-enhancing tumor in the right temporal lobe, which was diagnosed as CNS involvement in CLL on brain biopsy. High-dose methotrexate therapy was ineffective for this lesion, which was also resistant to subsequent whole-brain irradiation, treatment with fludarabine–cyclophosphamide–rituximab chemoimmunotherapy, and ibrutinib administration. Because no standard protocol exists for CLL with CNS involvement, it is important to accumulate case data to verify the choice of new drugs for administration at an early stage. Therefore, we also conducted a literature review of 50 case reports of CNS lesions in the last 10 years to consider the pathophysiology, diagnosis, and treatment of CNS involvement in CLL. The possibility of new therapeutic agents, eg, ibrutinib and venetoclax, or a combination of these agents and methotrexate, can be envisioned as a treatment strategy for CLL with CNS involvement.

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Section: Discussionmentioning

confidence: 99%

Refractory Chronic Lymphocytic Leukemia with Central Nervous System Involvement: A Case Report with Literature Review

Nakanishi

Ito

Fujita

et al. 2020

JBM

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“…A wide range of therapeutic modalities have been reported in sporadic cases (Stagg & Gumbart, 1987;Garicochea et al, 1997;Hagberg et al, 1997;Miller et al, 1997;Elliott et al, 1999;Poplawska-Szczyglowska et al, 1999;Rye et al, 2001;Brick et al, 2002;Remkov a et al, 2003;Knop et al, 2005;Mowatt et al, 2005;Watanabe et al, 2005;Hanse et al, 2008;Kakimoto et al, 2010;Cohen et al, 2012;Imitola et al, 2012;Moazzam et al, 2012;Strati et al, 2016), consisting of either IT, systemic immuno-chemotherapy or radiotherapy, combined or alone. Based on our results, FCR or BR with IT in first line seems an effective therapy, both for non-progressive and progressive CLL.…”

Section: Discussionmentioning

confidence: 99%

Management of central nervous system involvement in chronic lymphocytic leukaemia: a retrospective cohort of 30 patients

et al. 2016

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SummaryCentral nervous system involvement (CNSi) is a rare and poorly reported complication of chronic lymphocytic leukaemia (CLL). Establishing cause and effect between the CLL and the neurological symptoms remains challenging. We have analysed a retrospective cohort of 30 CLL patients with CNSi, documented by lymphocytic infiltration either by flow cytometry of the cerebrospinal fluid (CSF; n = 29) or CNS biopsy (n = 1). Neurological symptoms were heterogeneous. At the time of CNSi, less than half of the patients had a progressive CLL and 20 had never been treated for CLL. Initial treatment with fludarabine-based immuno-chemotherapy, with or without intra-CSF therapy, led to durable response in eight out of nine untreated patients. In contrast, 50% patients receiving various prior treatments needed additional therapy within a median of 4 months (1-16). Ibrutinib led to complete response in 4/4 heavily pre-treated patients. From CNSi, 5-year overall survival was 72% and 48% for treatment-na€ ıve and previously treated patients respectively (P = 0Á06); 5-year progression-free survival (PFS) was 43% and 0% (P = 0Á125). 17p deletion was significantly associated with poor PFS (P = 0Á006). CNSi may be the only sign of progression of CLL and should be considered an initiation criterion of systemic treatment. Prognosis seemed to be related to CLL characteristics rather than to CNSi itself.

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“…Two hundred seventy-two articles reported on 553 patients with otologic manifestations of hematologic malignancies, of which 255 (93.8%) were case reports and of OECBM level V evidence and 17 (6.2%) were case series and of OECBM level IV evidence (Supplement 3, http://links.lww.com/MAO/B834; Supplement 4, http://links.lww.com/MAO/B835) (4,5,7–10,13,14,19–282). While the largest proportion of articles originated in the United States (n = 83, 30.5%), the literature spanned countries across all continents.…”

Section: Resultsmentioning

confidence: 99%

A Scoping Review of Otologic Manifestations of Hematologic Malignancies

Raymond,

Ottinger,

Rowley

et al. 2024

Otol Neurotol

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Objective To examine the otologic and neurotologic symptoms, physical examination findings, and imaging features secondary to hematologic malignancies. Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, databases, including PubMed, Scopus, and CINAHL, were searched for articles including patients with otologic manifestations of leukemia, lymphoma and multiple myeloma. Data collected included patient and study demographics, specific hematologic malignancy, timing and classification of otologic symptoms, physical examination findings, imaging features and methods of diagnosis. Pooled descriptive analysis was performed. Results Two hundred seventy-two articles, of which 255 (93.8%) were case reports and 17 (6.2%) were case series, reporting on 553 patients were identified. Otologic manifestations were reported on 307 patients with leukemia, 204 patients with lymphoma and 42 patients with multiple myeloma. Hearing loss and unilateral facial palsy were the most common presenting symptoms for 111 reported subjects with leukemia (n = 46, 41.4%; n = 43, 38.7%) and 90 with lymphoma (n = 38, 42.2%; n = 39, 43.3%). Hearing loss and otalgia were the most common presenting symptoms for 21 subjects with multiple myeloma (n = 10, 47.6%; n = 6, 28.6%). Hearing loss and unilateral facial palsy were the most common otologic symptoms indicative of relapse in subjects with leukemia (n = 14, 43.8%) and lymphoma (n = 5, 50%). Conclusion Hearing loss, facial palsy, and otalgia might be the first indication of a new diagnosis or relapse of leukemia, lymphoma, or multiple myeloma. Clinicians should have a heightened level of suspicion of malignant etiologies of otologic symptoms in patients with current or medical histories of these malignancies.

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Hearing Loss due to Infiltration of the Tympanic Membrane by Chronic Lymphocytic Leukemia

Cited by 3 publications

References 12 publications

Refractory Chronic Lymphocytic Leukemia with Central Nervous System Involvement: A Case Report with Literature Review

Refractory Chronic Lymphocytic Leukemia with Central Nervous System Involvement: A Case Report with Literature Review

Management of central nervous system involvement in chronic lymphocytic leukaemia: a retrospective cohort of 30 patients

A Scoping Review of Otologic Manifestations of Hematologic Malignancies

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