Acute hemorrhagic leukoencephalitis in patients with acute myeloid leukemia in hematologic complete remission

The authors describe the cases of three patients affected by acute myeloid leukemia, in complete remission, who rapidly developed neurologic symp toms leading to death. Neither clinical characteristics, nor radiological or mi crobiological procedures, allowed an etiological diagnosis of the neurologi c syndrome. Post-mortem examination of the blain showed both macroscopic an d microscopic findings compatible with acute hemorrhagic leukoencephalitis. The difficulty in distinguishing this entity from other CNS disease-relate d complications (e.g. leukemia infiltration, drug toxicity, hemorrhages) sh ould not lead to an underestimation of the true incidence of this complicat ion. We believe that with more attention to the possibility of this complic ation there would probably be both a greater possibility of collecting clin ical informations about the real impact of this dramatic disease and a stro nger hope of finding the right treatment for it. (C) 1999, Ferrata Storti F oundation.