CHRONIC MYELOID-LEUKEMIA - A RARE CAUSE O F COCHLEOVESTIBULAR LESION

Background: Cochleovestibular lesions in patients with acute myeloid l eukemia or the blastic phase of chronic myeloid leukemia are usually d ue to leukemic infiltration, infection or hemorrhage. In contrast, the most likely cause of cochleovestibular lesions in the chronic phase o f the chronic myeloid leukemia seems to be disturbed microvascular per fusion and vascular occlusion, Case report: A 45-year-old patient with a chronic myeloid leukemia presented with the sudden onset of profund deafness in his right ear combined with a total loss of vestibular fu nction on the same side, The hemoglobin count was 10.5 g/dl; the white blood cell count 448 x 10(9)/l; the platelet count 71x10(9)/l, All of the plasmatic coagulation factors were in the normal range, The patie nt was treated with cytostatic drugs and responded well (rapid cytored uction), but the deafness persisted, Discussion: Cochleovestibular les ions in the chronic phase of the chronic myeloid leukemia are very rar e. The most likely cause in the case described above seems to be incre ased blood viscosity due to the high white cell count and alterations in the leukocyte rheology (leukostasis syndrome), Conclusion: In patie nts with leukemia and acute cochleovestibular lesions in contrast to o ther patients with sudden deafness and/or sudden loss of peripheral ve stibular function, a combination of chemotherapy and leukopheresis cap able of rapid cytoreduction is necessary, whereas a conventional hemor rheologic therapy seems to be insufficient.